APPENDICES: 2016 Community Health Needs Assessment

Transcription

APPENDICES: 2016 Community Health Needs Assessment
I.
II.
III.
IV.
V.
Health Need Themes by County (Key Informant/Public Health /Listening Sessions).......2
County Profiles - Health Indicators…….4
Maps
1. Priority Census Tracts by High Premature Death Demographic Cluster of High Contribution of County
Disease Burden…….14
2. Percent of Population without Insurance Coverage…….15
3. Percent of Population Below 100 Percent FPL…….16
4. Percent of Population Ages 25-64 with a Bachelor Degree or Higher Degree…….17
5. Percent of Population Ages 25-64 without a High School Diploma or Equivalent…….18
6. Number Years of Potential Life Lost (YPLL) by Census Tract of Residence in WellStar Five-County Service
Area…….19
7. Percent of Discharges by Cause – Cardiovascular…….20
8. Percent of Discharges by Cause – Diabetes…….21
9. Cobb County Population with Private Insurance…….22
Community Input Research Summaries
i. State and Organizational Leaders Key Informants (GHPC)…....23
ii. District Public Health Key Informants (GHPC)…….25
iii. WellStar Key Informant Survey/Interview Summary by County…….26
iv. Focus Groups (GHPC) in Five Counties…….34
v. WellStar Listening Sessions…….40
1. The CarePlace – Douglas
2. Good Samaritan Health Center of Cobb
3. Ser Familia – Cobb/Paulding
4. Bethesda Community Clinic– Cherokee
5. Paulding County Health Department – Paulding
6. Iglesia de Dios and McEachern UMC - Cobb
Research Tools
GHPC:
i. Key Stakeholder Interview Guide…….47
ii. Focus Group Guide…….48
Additional Community Commons Reports (available upon request – [email protected])
Transcripts (available upon request – [email protected])
WellStar: (Please note: SOME COMMUNITY RESPONSES MAY NOT REFLECT THE OPINION OR PRIORITIES OF WELLSTAR)
iii. Key Informant Survey/Interview Guide….51
iv. Listening Session Guide…….55
Transcripts (available upon request)
v. Key Informant Input…….58
vi. Community Online Survey Screenshots from Social Media Distribution…….112
vii. Community Online Survey and WellStar Medical Group Online Survey Guides with Responses
(highlights in Significant Health Needs Data Summaries and available upon request)
viii. A.L. Burruss Institute’s Prioritization Survey Used to Plot Health Needs at Health Needs
Summit…….115
1
HEALTH NEED THEMES BY COUNTY FROM PRIMARY DATA
These health needs are not listed in order of perceived importance.
BARTOW
Public Health/ Resident / Key Informant Priorities
Tobacco use
Maternal and infant health
Mental health
Chronic disease
Access to affordable care
Prevention/wellness education
Heart disease / stroke
Cancer
Obesity
Transportation
CHEROKEE
Mental health
Teen suicide
Chronic disease – Type 2 diabetes
Teen pregnancy and low birth weight
Substance abuse – heroin
Heart disease
COBB
Chronic disease
Obesity
Sexually transmitted diseases
Maternal/Infant health
Mental health
Cancer
Heart disease
Lack of safe and affordable housing
Substance abuse
2
DOUGLAS
Access and affordability of primary care
Quality of care
Chronic disease
Obesity
Mental health
Transportation
COPD
Substance abuse
PAULDING
Mental Health
Obesity
STDs
Chronic disease – Type 2 diabetes
Access to care
Transportation
Cancer
Heart disease / hypertension
Substance abuse
3
COUNTY PROFILES
County: Bartow (63rd) County Health Ranking 2015
Public Health /Resident Priorities
Teen Pregnancy and low birth weight
Tobacco use
Mental health
Chronic disease
Access to care (under and uninsured)
Socioeconomic
Poverty Rate (< 100% FPL) (2009-13)a
High School Graduation Rate (2011-12)a
Students Eligible for Free / Reduced Lunch
(2013-14)a
Unemployment Rate (2015)a
Uninsured Population (2009-13)a
Uninsured Children
(2013)a
Health Determinants
Tobacco Use - Cigarette Smokers (2006-12)a
Inadequate Fruit & Vegetable Consumption
(2005-09)a
Access to Exercise Facilities (2010/2013)b
Travel to work by transit, walk, or bicycle
(2009-13)c
Commute over 60 Minutes (2009-13)c
% Traffic Deaths Involving Alcohol (200913)b
Population: 100,382 US CENSUS BUREAU 2010-13
Age Group
(2009-13)a
0-17 yrs
18-64 yrs
65+ yrs
%
26.22
62.52
11.26
Racial/Ethnic
(2009-13)a
Black
Hispanic
Non-Hispanic White
%
10.39
7.80
79.04
Measure
Health Care Access
17.1% Primary Care Providers / 100,000 (2012)a
70.6% Dental Providers / 100,000 (2013)a
50.7% Mental Health Providers / 100,000 (2014)b
% of Adults with No Regular Doctor (20117.6% 2012)a
Federally Qualified Health Centers /
19.3% 100,000 (2014)a
% Population in Health Professional
10.1% Shortage Area (2015)a
Measure
Clinical Care & Prevention
21.3% Households Receiving SNAP (2009-13)a
HIV Screening Rate (2011-12)a
78.6%
82.1% % Smokers Attempting to Quit (2011-12)a
Physical Inactivity – 18+ yrs (2012)a
0.5%
10.2% Preventable Hospitalization (2012)a
Teen Birth Rate (2013)d
15.8%
Other Health Indicators
Poor physical health days (2006-12)b
Poor mental health days (2006-12)b
% Reporting poor dental health (2006-10)a
Years of Potential Life Lost (YPLL75) (2013)d
Mental health ER rate per 100,000 (2013)d
Self harm age adjusted discharge rate per 100,000 (2009-13)d
Assault age adjusted discharge rate per 100,000 (2009-13)d
Obs. Heart Disease/Heart Attack age adjusted discharge rate per
100,000 (2009-13)d
Hypertensive Heart Disease age adjusted discharge rate per
100,000 (2009-13)d
Asthma ER visit rate per 100,000 (2013)d
Motor Vehicle Crash ER visit rate per 100,000 (2013)d
HIV prevalence rate per 100,000 (2013)e
Low birth weight (< 2500g) per 1,000 births (2009-13)d
County
Measure
43.7
28.6
85
30.2%
1
100%
Measure
13.6%
42.5%
58.8%
26.1%
65
16
Georgia/Region
4.1
4.6
23.2%
8,391.6
1,344.90
56.3
9.4
3.5
3.3
12.9%
6,330.5
902.9
33
21.4
529.0
317.2
94.7
493.7
1,151.3
246.5
8.2
81.7
551.6
973.7
36.7
9.5
4
Infant mortality (total; non-Hispanic White; Black) (2009-13)d
8.1; 6.4; 15.1
6.1; 4.9; 10
Summary:
Bartow County is a relatively challenged area of the metro Atlanta/Athens CHNA community of practice
extended region. Levels of poverty (17.1%), near poverty (38.3%), unemployment (11.3%), lack of health
insurance (19.3%), and low college attendance (46.2%) are higher than in other counties. The county profile is
relatively rural and matches closely with overall socio-economic indicators for the state of Georgia. For instance,
the percentage of children in poverty is roughly the same as the statewide percentage, but nearly double the rate
of nearby Cherokee County. Nearly 20% of adults over 25 years lack a high school diploma or equivalent,
compared with 12.8% regionally and 15.3% statewide. While the Black population is relatively small compared
with the state or region, this portion of the population is not doing as well as the rest of the county, experiencing
higher unemployment rates. Rates of smoking are high (21.3%) compared with the rest of the region (15%), as
is physical inactivity is (26.1% of adults report no leisure time physical activity). At the same time, the county
reports high rates of inadequate fruit and vegetable consumption (78.6% compared with 74.2% regionally).
Additionally, there are very few opportunities to get incidental physical activity through active transportation,
relative to adjacent counties (even in the area with highest rate, 1.8% vs 12.4% in Cherokee County). Some of
these behaviors manifest in elevated rates of heart disease, with county residents hospitalized at the rate of 529
per 100,000 compared with 317.2 regionally. Diabetes rates are above average as well. The county also has
some of the highest rates of infant mortality, especially for Black and Hispanic babies. Teen births, suicides and
attempted suicide, and ER utilization for mental and behavioral health needs are very high compared with
regional rates (16 vs. 12; 56.3 vs 33; and 1344 vs 903). A very high percentage of Medicare enrollees suffer from
depression relative to other counties. Additionally, the percentage of people reporting poor physical health is
much higher than the region (19.7% vs 12.2%) as well as those reporting poor dental health (23.2% vs 12.9%).
Lack of services may be a factor, as there is a lower than average rate of primary care providers (43.7 as
opposed to 65.8 per 100,000 regionally) and dental care providers (28.6 vs 49.7 regionally). Just over 30 % of
adults report not having a regular doctor, which is twice the rate in Paulding County. A hundred percent of the
county is designated as a health professional shortage area, although it is served by a federally qualified health
center as a result. Just over 20% of the population is enrolled in Medicaid, which is double the rate of Cherokee
County. About one in eight members of the population has a disability, which is above average. Some bright
spots are lower than average rates of sexually transmitted infections and assaults. Drunk driving fatalities are
also lower than the state. However, the premature death rate remains elevated, at 8391 versus 6330 for the
region. Overall, chronic disease, mental health, unintentional injury, and teen pregnancy appear to be the
leading drivers of health needs here. Nine Census tracts in Bartow County exhibit the highest rates of the
county’s leading causes of morbidity and mortality, while five are located in Georgia Department of Public
Health Demographic Clusters with elevated rates of premature death; two Census tracts meet both criteria.
References
a. Community Commons CHNA Portal: CHNA.org
b. County Health Rankings and Roadmaps: countyhealthrankings.org
c. US Census Bureau, American Community Survey 5-Year Dataset: census.gov
d. Georgia Department of Public Health Online Analytical Statistical Information System: oasis.state.ga.us
e. Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB
Prevention (NCHHSTP): www.cdc.gov/NCHHSTP/Atlas/
5
County: Cherokee (6th) County Health Ranking 2015
Public Health/Resident Priorities
Teen Pregnancy and low birth weight
Tobacco use
Mental health
Chronic disease
Access to care (under and uninsured)
Socioeconomic
(2013-14)a
Uninsured Children (2013)a
Health Determinants
(2005-09)a
(2009-13)c
% Traffic Deaths Involving Alcohol (2009-13)b
Age Group
(200913)a
0-17 yrs
18-64 yrs
65+ yrs
%
Racial/Ethnic
(2009-13)a
%
27.07 Black
62.92 Hispanic
10.01 Non-Hispanic White
Measure
Health Care Access
9.8% Primary Care Providers / 100,000 (2012)a
73.0% Dental Providers / 100,000 (2013)a
25.1%
Mental Health Providers / 100,000 (2014)b
6.1% % of Adults with No Regular Doctor (20112012)a
15.5% Federally Qualified Health Centers /
100,000 (2014)a
10.4% % Population in Health Professional
Shortage Area (2015)a
Measure
16.7% Households Receiving SNAP (2009-13)a
74.5%
81.0% % Smokers Attempting to Quit (2011-12)a
1.5%
14.4% Preventable Hospitalization (2012)a
16.9% Teen Birth Rate (2013)d
Self harm age adjusted discharge rate per 100,000 (2009-13)d
100,000 (2009-13)d
Hypertensive Heart Disease age adjusted discharge rate per 100,000
(2009-13)d
County
5.87
10.06
80.39
Measure
32.1
49.3
81
20.4%
0.47
0%
Measure
6.7%
39.9%
54.9%
21.5%
57.9
8.5
Georgia/Region
2.9
2.7
12.3%
5,527.3
824.1
32.4
7
3.5
3.3
12.9%
6,330.5
902.9
33
21.4
335.7
317.2
43.2
271
710.8
156.4
7.3
5.5; 4.9; 9.1
81.7
551.6
973.7
36.7
9.5
6.1; 4.9; 10
6
Summary:
Cherokee County is a relatively healthy and advantaged part of the CHNA region, due in large part to a
concentration of wealth. Nonetheless, there are three socio-demographically challenged Census tracts in the
county and four tracts that contribute to elevated rates of morbidity and mortality; two Census tracts meet both
criteria. Advanced age and rurality are two of the primary risk factors present for county residents, while
isolated pockets of low resource areas suffer the highest rates of premature illness and mortality. Leading
causes of hospitalization include falls, mental illness, and drug overdose. Unintentional poisoning is also a
concern. The county enjoys some of the lowest levels of poverty (9.8%), unemployment (8.1%), and reliance on
public assistance, and high levels of educational attainment and health insurance coverage. But even as a high
performer in the state and region, one in ten county residents lives in poverty, one in ten relies on Medicaid,
the high school graduation rate is ten percentage points behind high-performing counties in the rest of the
nation, and the Black unemployment rate is 50% higher than the average rate for the county. About one third of
households pay over 30% of their income for housing, which is lower than the state average. The county enjoys
a high ratio of fitness facilities (11.2) and some walkable areas where more than one in ten commuters can
walk, bicycle, or take transit to work. Healthy behavior rates, such as smoking, eating fruits and vegetables, and
partaking in physical activity are average. However, the number of smokers who have attempted to quit in the
last year is relatively low (54.9% vs 64.5% regionally). Although the county does not constitute a health
professional shortage area, the ratio of primary care providers is about half the regional average (32.1 vs 65.8).
Compared with the rest of the region, Cherokee County enjoys very low rates of poor physical, dental, or mental
health, and a premature death rate below the regional average.
References
7
County: Cobb (4th)
Access to primary care
Chronic disease and obesity reduction
Infectious disease (HIV, syphilis)
Teen pregnancy
Mental health
Socioeconomic
(2011-12)a
High School Graduation Rate
(2013-14)a
Uninsured Children
County Health Ranking 2015
(2013)a
Health Determinants
(2005-09)a
(2009-13)c
Age Group
(2009-13)a
0-17 yrs
18-64 yrs
65+ yrs
Measure
12.8%
75.2%
39.6%
6.6%
18.3%
11.6%
Measure
14.1%
70.6%
88.5%
2.2%
9.7%
%
25.29
65.43
9.28
Racial/Ethnic
(2009-13)a
Black
Hispanic
Non-Hispanic White
%
25.59
12.64
54.78
Health Care Access
Primary Care Providers / 100,000
(2012)a
Dental Providers / 100,000 (2013)a
Mental Health Providers / 100,000
(2014)b
% of Adults with No Regular Doctor
(2011-2012)a
100,000 (2014)a
Measure
Households Receiving SNAP (2009-13)a
Measure
8.6%
(2011-12)a
% Smokers Attempting to Quit
Preventable Hospitalization
(2012)a
68.6
63.9
133
21.6%
0.73
0%
44.9%
64.9%
18.5%
53.1
26.1%
Self-harm age adjusted discharge rate per 100,000 (2009-13)d
100,000 (2009-13)d
Hypertensive Heart Disease age adjusted discharge rate per
100,000 (2009-13)d
8.8
County
Georgia/Region
2.7
2.8
9.6%
5,442.0
857.0
31.7
11.3
3.5
3.3
12.9%
6,330.5
902.9
33
21.4
272.3
317.2
74.6
529.8
900.5
350.7
8.3
5.9; 4.2; 11
81.7
551.6
973.7
36.7
9.5
6.1; 4.9; 10
8
Summary:
Cobb County is a diverse and rapidly growing county. Just over 12% of the population is Hispanic, high for the
region, and 25.6% identify as Black. Less than 5% of households are reported as being linguistically isolated,
meaning that no one in the household over 5 years old is proficient in English. The county performs on par or
slightly better than the region in many social measures, such as poverty, lack of insurance, and unemployment.
Almost 3 in every 4 adults over 25 years have attended college versus 60.8% statewide. Only 12.5% of residents
have Medicaid versus 17.3% region-wide. At 9.7%, far fewer county residents have commutes over an hour than
adjacent counties. As many as 22.8% of households lack access to a car in one Census tract. The county has a very
high index of fast food establishments, but also a very high proportion of fitness facilities. The county also has
relatively low rates of physical inactivity (18.5% vs 22.3% regionally) and inadequate fruit and vegetable
consumption (70.6% vs 74.2%). In some areas, over 16% of commuting adults get additional physical activity
through active transportation modes. Tobacco usage, 14.1%, is far lower than the regional rate, 18.1%. The county
has above average rates of primary care providers (68.6 for every 100,000 residents) as well as dental providers
(63.9) and mental health providers (133). Cobb County has very low rates of years of potential life lost (YPLL) at
5442 compared with 6330 in the region. Almost 10% of residents report that they are in fair or poor health
compared with 12.2% regionally. Similarly, 9.6% reported poor dental health compared with 12.9% in the region.
The county has low rates of hospital usage for mental health, suicide/self-harm, and heart disease. However, the HIV
diagnosis rate is extremely high, at 350.7 per 100,000 population. While the overall infant mortality rate is slightly
below average (5.9 vs 6.1), it is above average for Black infants (11 vs 10).
References
9
County: Douglas (27th) County Health Ranking 2015
Access to primary care
Quality of care
Chronic disease and obesity reduction
Teen pregnancy
Mental health
Socioeconomic
(2013-14)a
Uninsured Children
(2013)a
Health Determinants
Tobacco Use - Cigarette Smokers (200612)a
(2005-09)a
(2009-13)c
Population: 133,486
Age Group
(2009-13)a
0-17 yrs
18-64 yrs
65+ yrs
Measure
16.1%
72.0%
50.0%
7.9%
18.3%
9.7%
Measure
%
27.93
63.01
9.06
US CENSUS BUREAU 2010-13
Racial/Ethnic
(2009-13)a
Black
Hispanic
Non-Hispanic White
%
41.09
8.87
46.15
Health Care Access
(2012)a
(2014)b
(2011-2012)a
100,000 (2014)a
Measure
Measure
41.8
44.7
71
25.8%
0
0%
14.8%
14.5%
84%
75.4%
1.9%
13.3%
48.9%
% Smokers Attempting to Quit (201112)a
Preventable Hospitalization (2012)a
28.4%
100,000 (2009-13)d
(2009-13)d
78.4%
26.1%
67.7
13.2
County
3.2
3.5
12.1%
6,998.4
1,120.40
40.2
12.7
Georgia/Region
3.5
3.3
12.9%
6,330.5
902.9
33
21.4
420.4
317.2
101.4
773.6
81.7
551.6
10
1,435.70
201.6
9.6
7.7; 7.4; 9.8
973.7
36.7
9.5
6.1; 4.9; 10
Summary:
Douglas County is similar to the CHNA community of practice region in age distribution and birth rate, as well as
educational attainment. It is more diverse than nearby counties at 41.1% Black, 46.2% non-Hispanic White, and
8.9% Hispanic. The percent of children in single parent homes, 38%, is higher than the surrounding area. Poverty
rates exceed the regional average, and a quarter of children in the county live in poverty. 18.3% of the population is
uninsured and another 19% have Medicaid coverage. The total unemployment rate is high at 13.2%, and within
subpopulations, the rate is elevated for both Black and non-Hispanic White. Like the region, over 36% of
households are cost-burdened by housing expenses. Douglas County has much lower ratio of fitness facilities per
100,000 residents (4.53 vs 9.3 in the region). At 84%, the county has very high rates of inadequate fruit and
vegetable consumption (the regional average is 74.2%). Additionally, 26.1% of adults do not get any physical
activity, 4 percentage points above the regional average. Smoking rates are relatively low (14.8%) and 78.4% of
smokers had attempted to quit, which is much higher than the regional average and national best performers.
However, 28.4% of adults report driving drunk, which could be associated with the rate of ER utilization for motor
vehicle crash injuries (1435.7 vs 973.7). The county has below average ratios of mental health, dental health, and
primary care providers. Compared with 12.2% of people in the region, 16% of Douglas County residents report fair
or poor physical health. The county also reports above average rates of hospital and ER utilization for mental health
needs, although the rate of depression among Medicare enrollees matches the regional average. ER utilization for
pregnancy and childbirth is much higher than the region (1283.2 per 100,000 vs. 887.1 per 100,000). The county
also indicates higher than average rates of teen births, low birth weight, and infant mortality. Compared with the
region, the county also has elevated rates of asthma (773.6 vs. 551.6 per 100,000), hypertension (101.4 vs. 81.7, per
100,000), and chlamydia (478 vs. 421 per 100,000).
References
11
County: Paulding (14th) County Health Ranking 2015
Mental Health
Obesity
STDs
Chronic disease reduction
Access to care
Socioeconomic
(2013-14)a
Uninsured Children
(2013)a
Health Determinants
(2005-09)a
Population: 143,845
Age Group
(2009-13)a
0-17 yrs
18-64 yrs
65+ yrs
Measure
11.4%
75.0%
32.9%
6.6%
14.3%
10.1%
Measure
19.9%
73.7%
81.1%
(2009-13)c
1.1%
21.1%
13.2%
%
29.47
62.73
7.80
US CENSUS BUREAU 2010-13
Racial/Ethnic
(2009-13)a
Black
Hispanic
Non-Hispanic White
%
17.18
5.35
74.39
Health Care Access
(2012)a
(2014)b
(2011-2012)a
100,000 (2014)a
Measure
Measure
9.4%
12.4
14.3
33
15.5%
0
0%
% Smokers Attempting to Quit (201112)a
Preventable Hospitalization (2012)a
100,000 (2009-13)d
(2009-13)d
County
42.0%
42.3%
26.7%
77.6
9.9
Georgia/Region
4.8
4.2
17.7%
5,711.0
1,007.10
40.9
9.1
3.5
3.3
12.9%
6,330.5
902.9
33
21.4
443
317.2
70.4
452.5
1,253.50
81.7
551.6
973.7
12
46.1
7.1
3.6; 3; 6.9
36.7
9.5
6.1; 4.9; 10
Summary:
Paulding County has a high index of children (29.7%) compared with 26% regionally, and a lower than average
index of older adults (7.8% vs 9.6%). It has few linguistically isolated households. The county has relatively low
poverty rates especially for children, although 11.4% of county residents and 14.9% of children still live in poverty.
At 60.6%, the percent of adults who have attended college is comparable with the statewide average but lower than
many of the adjacent counties. Along with low poverty rates, there are also lower rates of un-insurance, Medicaid
enrollment, and other public benefits. However, unemployment is still prevalent, particularly for Black (14.2%) and
Hispanic (12.4%) residents. Notably, over 21% of county commuters spend over an hour traveling each way to
work. Paulding County residents are less likely to report participating in a civic or social association (5.3% vs 9.0%
statewide). The county also posts the one of the highest rates of physical inactivity, 26.7% of all adults (versus
22.3% regionally). Smoking rates are above average at 19.9% versus 15%, and just 42.3% of smokers had tried to
quit compared with 64.5% region-wide. There are relatively few fast food outlets relative to the population.
Relatively few adults report driving drunk (13.2%). The rate of healthcare providers is very low per 100,000
residents, at 12.4 primary care providers (vs 65.8 regionally), 14.3 dental providers (vs 49.7), and 33 mental health
providers (vs 109). However, there are no health professional shortage areas in the county and only 15.5% of
residents lack a regular doctor, compared with 25.7% regionally. The preventable hospitalization rate is high at
77.6 per 1,000 population, compared with a statewide average of 60.6. Although the county’s rate of premature
death or years of potential life lost is on the low end, county residents report a very high number of days of poor
physical health per month, with 4.8 days per month versus 3.5 days statewide and just 2.9 days in nearby Cherokee
County. They also report almost one additional day per month of poor mental health (4.2 vs 3.3). Infant mortality
rates, sexually transmitted infections, and teen birth rates are low. However, emergency room (ER) utilization rates
for pregnancy and for mental health are both above average. Suicide or self-harm rates (40.9) are also higher than
the regional average (33). The county also demonstrates elevated rates of diabetes (12.7% vs 10%) and
hospitalization for obstructive heart disease or heart attack (443 vs 317 per 100,000 population). The rate of ER
visits for traffic-related injuries is above average as well. Diseases of advanced age tend to be leading causes of
death and hospitalization, while suicide and unintentional poisoning are elevated causes of premature death.
Mental and behavioral health needs are elevated.
References
13
MAP 1
14
MAP 2
15
MAP 3
16
MAP 4
17
MAP 5
18
MAP 6
YPLL: Years of potential life lost involves estimating the average time a person would have lived had he or she
not died prematurely. This measure is used to help quantify social and economic loss owing to premature
death, and it has been promoted to emphasize specific causes of death affecting younger age groups.
19
MAP 7
20
MAP 8
21
MAP 9
22
COMMUNITY INPUT RESEARCH SUMMARY REPORTS:
KEY INFORMANT SUMMARY (STATE AND ORGANIZATIONAL LEADERS)
As part of a broader network of key informant interviews with health stakeholders in Atlanta, the GHPC interviewed
individuals from the following organizations regarding their assessment of health and opportunities for health
improvement in the WellStar service area:








Nursing Director (Bartow), and Donna Stafford, Nursing Director (Paulding) – District 1-1
North Georgia Health District Director (District 1-2)
Deputy Director to John Kennedy, District Health Director (Cobb & Douglas, District 3-1)
Georgia Department of Education
United Way
Center for Pan Asian Community Services
Atlanta Regional Commission
Community Foundation of Greater Atlanta
Major Health Challenges and Drivers










Chronic disorders
Access and affordability of health insurance or viable alternatives
Health equity, and literacy; lack of resources that are linguistically and culturally appropriate
Inequalities in determinants of health
The need for increased investment in prevention
Health education programs built on behavior change and physical activity are not equal across all counties in the
state
Transportation to care
Preventive care among men
Good health in early childhood
Workforce development
Recommended Interventions:








Implement models focused on care coordination
Disease management approaches that facilitate better eating and active living
Attempt interventions that tackle social inequities; stabilizing people’s lives so that they can get and hold good
jobs
Address language barriers, lack of transport, and resources for preventive care for underrepresented
communities
Support efforts to collect and analyze data about disaggregated communities
Get preventive care resources to targeted at-risk populations to prevent/reduce unnecessary use of emergency
care and development of disease.
Establish more safety net care facilities.
Invest in community health workers
23


Health education in all areas (mental health, substance abuse etc.) behavioral change, comprehensive health
education
Direct resources to ensuring good health in early childhood –
o address parents’ issues before children are born, access to good food, language nutrition
o Facilitate quality education opportunities in health and physical education, including access to physical
activity opportunities before, after and during school within communities
o Safe playgrounds, places to play outside
o Participate in comprehensive health education movement for student K 12.
o Make it easy for kids and families to access healthy food at a reasonable price, recreation programs and
live in walkable communities
o Use messages that focus on "improving children's health", as opposed to "obesity prevention"
24
Major Health
Challenges
Cobb/Douglas
KEY INFORMANT SUMMARY - DISTRICT PUBLIC HEALTH
GHPC
Cherokee
Bartow
Paulding

Access to primary
care
Chronic disease
Infectious disease
(HIV and syphilis)
Infant mortality and
low birth weight in
minority
populations

System focus on
episodic care
Pockets of poverty
throughout district
Growing diversity
and language
barriers
Limited and
diminishing funding
of public health
programs

Reimbursement
rates for Medicare
and Medicaid
populations
Invest in prenatal
and youth
education programs
Promote self responsibility
Connect health
plans and hospitals
in addressing issues




Context and
Drivers




Recommendations












Teen pregnancy
and low birth
weight
Tobacco use
Mental health
and substance
abuse
Access to care
Chronic disease


Engrained
unhealthy
behaviors
Insufficient
number of
healthcare
providers

Teen education
programs and
long-acting
reproductive
contraceptives
(LARCs)
School and
college-based
programs aimed
at preventing
tobacco use
Smoking
cessation
programs for low
income
communities
More mental
health providers







Access to care
Minority men's
health
Hypertension
Diabetes

Partners are
overwhelmed by
extent of need
Reduced funding
to chronic
disease
programs





Low access to
affordable care
Relatively high
numbers of
uninsured and
under-insured
Transportation to
care in rural areas
Low education
attainment
Ongoing cycle of
poverty
Poor eating habits
Teaching healthy behaviors (e.g. tobacco
prevention/cessation, obesity, nutrition)
SHAPE program for youth
Addressing safe sleep – high mortality
among infants, basic prevention through
education
More affordable and accessible primary
prevention efforts
25
KEY INFORMANT SUMMARIES ORGANIZED BY COUNTY – Multi-Sectors1
Third-Party Consultant
Bartow County:
Health and Quality of Life:
 Poor / declined as many people can’t afford ACA and no providers accept it or Medicaid
 Very few resources
 Pockets of high employment, drug use, poverty and crime (Emerson, Allatoona Elementary School area -30101,
30137), Adairsville and 30137 and 30102.
Major Health Challenges:













Access to healthcare
Diabetes
Hypertension
Obesity
Heart disease / stroke
Breast, cervical and lung cancer screening
Dental
Poor nutrition
Drug use
Alcohol use
Tobacco use
Infant mortality
Men’s health
Context and Drivers:







Cartersville Medical Center is a for profit hospital and accepts patient to a limit - “demand exceeds supply”
Limited resources and employment opportunities
Lack of transportation is a major barrier to care access and education
Bartow pays nurses less and funding is down at the Health Department
Co-sleeping is common in lower income families
Inadequate/unaffordable housing
Lack of insurance

Primary prevention through education and access to affordable healthcare
1
Stakeholders representing public health, school system, safety net clinics, county senior services, governmental agencies, Children’s Healthcare of
Atlanta, higher education, small business, non-profits, mental health, fire, police, Chamber of Commerce, emergency services, Hispanic health nonprofit, children’s advocacy, etc.
26






Engage faith-based community
Nutrition education and other programs
Health screenings with a follow-up process in place
Prescription assistance program
Youth programs
WellStar engagement by paying for a NP to assist
Cited Health Assets:




Allatoona Resource Center
Bartow Access Health
Schools, congregations, social media
Keith Saddling, CEO of Cartersville
Cherokee County:
 Improved from an increase of medical facilities and healthcare providers
 Good economic growth
 Expanded hospital services with the new Northside Cherokee, WellStar Health System and CHOA urgent care
locating to Cherokee

30114 and 30189 cited as low-income and the Bethesda population predominantly from 30114, 30115, 30188,
30189, and 30102.
 Access to care (especially wellness and preventative care such as vaccinations among the Latino population and
for children requiring services at home / school)













Language barrier
Diabetes
Hypertension
Cardiovascular disease
Obesity
Physical inactivity
Teen pregnancy / suicide
Cancer
Tobacco use
Poor nutrition
Mental health
Dental
Substance abuse (prescription and illegal drugs, especially heroin)
27


Asthma/COPD
Children’s health and wellbeing






Lack of affordable health services - many people are using the community clinics because they can no longer
afford the ACA insurance plan or find a provider that will take the insurance. Also, those who are insured with
high deductibles can’t afford to meet the deductible.
Large Latino population in the county (many undocumented)
Uninsured and underinsured due to low socioeconomic status and unemployment
Lack of health / nutrition education
Transportation issue
Decreased staffing a local health department









Centralized process to access resources in county and help to access Peach Care and employment services
(currently Cherokee residents have to go to Marietta)
Access to affordable mental health services and counseling
More health education in clinics / community / schools – diabetes, cardiac, mental health, tobacco cessation,
dental
More collaboration between clinics, hospitals, physicians, dentists, and social workers to fill care gaps
Transportation to health resources.
Teen suicide initiatives as rate is extremely high in county
Center to house medically fragile students to meet needs under one roof
Sliding scale services and education targeted to low-income families
More education relating to noted health challenges incorporated in the county through partnerships with clinics,
schools and faith-based organizations/congregations









Drug-Free Cherokee
Schools and school nurses – first line of medical care for many children
Bethesda Community Clinic
Cherokee Focus – meets monthly to share resources and connect the needs of the community with available
resources
Kaiser Permanente – provides specialty referrals at no cost at Bethesda
WellStar Health System – provides labs and imaging which has helped manage chronic disease and medications
at Bethesda
Children’s Healthcare of Atlanta urgent care
Cherokee Health Department provides some sliding scale community services with tracking and follow-up
Cherokee County Service League
28
Cobb County:



Good / very good with improvements to health and quality over the last three years with Cobb / Douglas Health
District faring better than the state of Georgia in many health indicators
Hospital closed (Emory Adventist) resulting in care shrinkage
More focus on health and wellness with Chamber’s involvement, public-private partnerships and Cobb2020
work
 Lack of affordable healthcare / resources
 Cardiovascular disease (high blood pressure/high cholesterol)
 Cancer screenings
 Obesity
 Tobacco use
 Infant mortality
 Tobacco use
 Chronic disease
 Diabetes (Type 2)
 Asthma
 Physical inactivity
 Poor nutrition
 Mental health
 Substance abuse (alcohol and opioids/heroin and prescription drugs)
 Lack of affordable housing for low-income and elderly
 Transportation
 Language barrier
 Sexually transmitted diseases
 Dental care
 Violence





More health facilities equals more access to care and convenience for the broader population and insured, but
there’s been no increase in facilities for the indigent, low-income population (Good Samaritan Health Center of
Cobb is centrally located in Cobb’s only official Medically Underserved Area and Health Professional Shortage
Area)
Community clinics are understaffed, closing, relocating and a Cobb hospital has closed and lack needed access to
specialists and primary care
Undiagnosed mental health issues underlie chronic disease management which is often overlooked
Lack of amenities to address health and fitness in lower income areas
Unemployment and underemployment
29












Not going to the doctors for check-ups /screenings
Food scarcity/deserts in Cobb (South Cobb/Austell) have not been adequately addressed although more options
are available via local farmer’s markets, community grocery stores and in school lunches
Lack of affordable healthcare / insurance options despite the advent of the ACA, Cobb continues to see the same
amount of uninsured which limits or eliminates medical care and preventative care visits/screenings
Rising deductibles of most insurance policies are making it difficult for many people to pay which self-imposes a
lack of care access
Lack of health literacy and awareness of available resources
Rising population of Latino population in county and the lack of access to culturally and linguistically appropriate
services
Need for more recreational infrastructure and amenities
Lack of recognition and treatment of addiction as a disease and limited recovery support
Health disparities track with areas with a significant number of individuals and families who are at or below the
federal poverty level, low education attainment, mixed ethnicity, limited English proficiency and poor health
literacy.
Emergency department utilization for primary care
Affordability factor of health services makes lack of money as the primary barrier to care due to unemployment
and underemployment
Reconsider patient education flyers and one-day health fairs where a community member finds out they have
high blood pressure, but have no physician for medication or follow-up care










More collaboration among healthcare providers, communities, public health and community-based
organizations targeting health challenges. Create policy to positively impact the socioeconomic determinants of
chronic disease requires collaboration of multi stakeholders.
Partner with faith-based congregations and other organizations to educate and assist with healthcare initiatives
and preventative care
Increase funding and resources for mental health services
Create grant funding for local community-based programs/health fairs/education with appropriate follow-up to
address health needs in communities with health disparities to show commitment to community benefit
services
More challenging wellness education (not just chronic disease management) and outreach campaigns (webbased) surrounding issues such as exercise / diet because of obesity’s direct correlation to health issues like
hypertension, cancer, Type 2 diabetes, etc.) especially in the schools and continuing throughout high school and
in the workplace
More access to primary care, specialty and mental health providers in Good Samaritan and other community
clinics
Hire a nurse practitioner to help increase patient load of community clinics (do urgent care or Coumadin checks)
Utilize community health workers to educate high-risk communities
Increase tobacco tax (Georgia has one of the lowest in the country) and use funds for healthy lifestyle
programming in high-risk communities
Creating lifelong communities (http://www.atlantaregional.com/aging-resources/lifelong-communities)
30
 Power Up for 30 in Cobb and Marietta schools
 Community clinics – Good Sam and Community Health Center in Austell
 Farm Fresh Farmer’s Markets
 Faith-based community
 Cobb Community Services Board
 WellStar Health System
 Ser Familia
 SafePath Children’s Advocacy Centers
 Culinary Sustainability within Culinary Services at Kennesaw State University (focused on farm to table and lower
food waste)


American Cancer Society’s Client Navigators (Georgia Breast and Cervical Cancer Program) – Breas Test Program







Fit City Kennesaw









Cobb Community Transit FLEX
Georgia’s CORE services program – allowed for people to qualify for health/mental healthcare insurance
coverage and funding for home-based care is vital to removing the access issue
Smyrna Tobacco Free Parks
Children’s Healthcare of Atlanta
MUST Ministries
Cobb Resource Center
Cobb Senior Services
Chronic Disease Council under the Chronic Disease Prevention Section of the Georgia Department of Public
Health
Cobb2020
WellStar Health Park (Vinings – South Cobb)
Alive Ministries
“Maestros Nanos” pediatric clinic (run by NPs to provide pediatric services to most vulnerable)
YWCA
Wal-Mart/Walgreen pharmacies
WellStar Cobb and Kennestone hospitals’ Emergency Department
Kaiser Permanente
Douglas County:
 More accessibility, services and awareness of the services
 Still lacking access necessary to manage chronic conditions
31











Affordability and access to healthcare
Obesity
Diabetes
Hypertension
Drug abuse (illegal and prescription)
COPD
Poor nutrition
Mental health
Physical inactivity
Transportation
Unhealthy/unsafe home conditions





Low-income and homeless population are prevalent
Unemployment and underemployment – high number of minimum wage employees
Lack of transportation to and from services
Lack of health education
Lack of primary care providers



Increase awareness of healthy living services/education/activities for children and adults – partnership with
county schools and businesses to reduce drug abuse, poor eating and lack of exercise
Provide more funding / resources for free clinics
School-based health centers

The CarePlace
Paulding County:
 Good to fair with some improvements to specialty and emergency care due to the opening in 2014 of the new
WellStar Paulding Hospital that’s more centrally located in county

Some decline due to lack of jobs and insurance


Lack of access to affordable healthcare services, especially primary care providers and labs for chronic disease
management / medications
Transportation
32











Obesity
Diabetes
Cancer
Substance abuse (alcohol, illegal and prescription drug)
Tobacco use
COPD
Cardiovascular disease
Hypertension
Mental health
Sex education
Domestic violence










Underinsured and underemployed and the children of these people who need medical services - high
deductibles - associated with a lower monthly premium plans – are too high for low-income residents
Pockets of poverty evident by government housing, run-down mobile home parks and inadequate housing
Lack of healthy food choices
Not going to the doctor for check-ups and screenings
Lack of jobs in Paulding – many people have to commute
Lack of transitional housing and homeless shelters in county
Vulnerable populations need no cost education (homeless, low-income, mentally ill, disabled not yet receiving
benefits, drug abusers, Latinos)
Failure of Georgia to expand Medicaid is a barrier to improving health
Lack of primary care and mental health providers and no low-cost options for these services
No safety net clinic to see indigent patients and provide access to needed medications at a free or reduced cost








Partnership with the Paulding Community Health & Resource Center as the first safety net clinic in the county
More community collaboration between governmental health agencies, non-governmental healthcare
organizations and faith-based community organizations and congregations
Prevention education (i.e. health fairs) to address behaviors (nutrition, exercise, smoking) in community and
schools
More access to preventative screenings, mental health interventions and immunizations
More supportive resources for alcohol and drug abusers
More recreational spaces and facilities
Public transportation
A birthing center in Paulding




WellStar Paulding Hospital
Paulding Community Health & Resource Center
Georgia Shape program
Paulding Family Connection Children’s Cabinet
33









Helping Hands of Paulding and its collaboration with Community Supplemental Food Program for Senior Citizens
60+ years of age
Paulding Meth Alliance / Family Alliance of Paulding
Ser Familia
Creating Communities of Hope (Paulding is a part of the Northwest Georgia Region of Hope)
Paulding County Health Department
Rapha Clinic in Temple (Carroll County)
Paulding County Community Support Services
Children’s Medical Services
Children’s Cabinet
FOCUS GROUPS
Focus groups were conducted by the Georgia Health Policy Center with insured and uninsured adults living in the high
need areas in the service area using a series of questions aimed at understanding perceptions of health needs and
solutions/resources to improve health.
County
Venue
Number of Participants
Cobb (Spanish)
South Cobb Regional Library
805 Clay Rd.
Mableton, GA 30126
Holiday Inn Express
7101 Concourse Parkway
Douglasville, GA 30134
Best Western Mountain Villa
705 Transit Avenue
Canton, GA 30114
Goodyear Clubhouse
3 Goodyear Avenue
Cartersville, GA 30120
Best Western
1340 Pace Rd
Hiram, GA 30141
10
Douglas
Cherokee
Bartow
Paulding
Overall
Male
Female
25-34
34-44
45-64
65+
Total
12
29
7
17
17
0
African
American
18
8
7
9
7
Asian
Caucasian
Hispanic/Latino
1
13
10
34
COMMUNITY FOCUS GROUP INPUT - COBB COUNTY (LATINO )
GPHC
1.
2.
3.
4.
5.
Obesity
Tobacco
Cancer
Diabetes
Mental health/substance abuse














Unhealthy food in schools
Healthy foods are expensive
Cultural norm of consuming a lot of meat and carbohydrates
Busy lives - not enough time available for meal preparation at home
Not enough resources available for family caregivers
Life stressors
Decreased ability to move and exercise in some members of the population whose health is already poor
Health philosophy that is centered on care - "Here in the United States, the western world, we see the human
body as if everything was separated by sector"
Safety concerns
Pervasive drug culture and use among youth
Youth sexual hyperactivity
Unaffordable access to care; limited availability of care providers during weekend
Linguistically appropriate engagement and community health workers only available during week days
Health department seen as primary care home for many without insurance
Recommendations:





More targeted educational campaigns aimed at promoting health and wellbeing - WellStar and Kaiser already
facilitating coaching classes
Engage churches, libraries and businesses
Go beyond trying to connect with parents through children using communications (notes, pamphlets etc.) sent
from school
Consider innovative ways to get families getting healthier together - e.g. bicycle day in cities
Encourage doctors to take more time at visits to educate patients
35
COMMUNITY FOCUS GROUP INPUT - DOUGLAS COUNTY
GHPC
1.
2.
3.
4.
5.
Mental health and substance abuse
Obesity
Sexually transmitted diseases (STDs)
Heart disease
Diabetes













Unhealthy eating habits
Limited choices for healthy foods
Poor public transportation system
Long working hours affectability to exercise
Difficult to change unhealthy behaviors
Many parks around but access may be challenging because of distance
Family history and culture of tobacco use (smoking)
Liquor and meth use prevalent
Youth risky sexual behavior and early initiation seeming more commonplace
Poor healthcare provider quality
Hard to be own advocate
Many battling despair and stress
Immigrants ( Asian, Hispanic and Caribbean) have challenges adjusting and navigating health system
Recommendations:





Environment changes that will facilitate youth socialization and physical activity o Accessible basketball/other courts
o YMCA
Improve transportation system to allow access to health and wellness resources
Address access to healthy foods - more quality restaurants and grocery stores
Work with other partners to assist community members in finding jobs
Encourage the Arts, and support of the Arts in the community
36
COMMUNITY FOCUS GROUP INPUT - CHEROKEE COUNTY
GHPC
1.
2.
3.
4.
5.
Cancer
Obesity
Diabetes
Hypertension/stroke





Hectic schedules and stress influence insufficient physical activity and poor eating
Confusion about what is healthy (e.g. organic vs. canned vegetables)
Lack of parental involvement and poor or no social connections influence drug abuse and risky sexual
behavior
Drugs are something to do and look cool
Few sidewalks and parks in neighborhoods for walking
Recommendations:



A safe community center for community activities
Health classes-eating and cooking
Public transportation options
37
COMMUNITY FOCUS GROUP INPUT – BARTOW COUNTY
GHPC
1.
2.
3.
4.
5.
Obesity, (unhealthy eating habits and insufficient physical activity)
Affordability of healthcare and insurance
Substance abuse
Tobacco use
Risky sexual behavior among teens






Unhealthy food is cheaper and readily available
High cost of insurance and healthcare
Hard to find time to do physical activity and cook/eat healthy because of time spent at work and other
family obligations
High levels of stress
Less parental involvement (drug abuse & risky sexual behavior)
Some disappointment with quality of care at Cartersville Medical Center
Recommendations:





Facilitate the establishment of more farmers' markets in the community
Support a neighborhood/civic center that offers community activities
Consider opening a gym or recreational facility that is open or free to the public;
Invite YMCA to participate
Work with other stakeholders to reduce the number of uninsured residents
38
COMMUNITY FOCUS GROUP INPUT – PAULDING COUNTY
GHPC
1.
2.
3.
4.
5.
Obesity
Sexually transmitted diseases (STD)
Hypertension/Stroke
Cancer











Change means going against the grain
Unable to find time and discipline to exercise; hard to find motivation
Costly gym membership
Easy and convenient access to fast foods
Unawareness of how to cook and prepare meals
Tobacco use (smoking) still an issue; many who try to stop smoking, gain weight
Established drug culture with seemingly increasing use of heroin
Early sexual initiation in youth
Busy schedules resulting in diminished parenting; television reinforcing unhealthy behaviors
Drug and alcohol poisoning putting burden on emergency rooms
Poverty, lack of insurance, child abuse (including trafficking) and family breakdown are also believed to
be driving health challenges
Recommendations:





Focus on addressing root causes of drug abuse and mental health conditions
Pattern drug use policy for Ritalin and Prozac to help control abuse of prescription meds
Promote teen pregnancy prevention programs that work
Engage churches and hospitals as information hubs
Support the use of joint use agreements especially with schools to be encourage youth and adults in the
community to exercise
39
Community Listening Session – COBB COUNTY (Latino)
Third-Party Consultant with assistance by Ser Familia Executive Director








Lack of affordable healthcare and insurance
Language barriers
Mental health among youth
Suicide
Domestic violence
Lack of available pediatricians
Diabetes
Dental









Scarce family support services
Little bi-lingual school personnel and medical providers
Lack of cultural proficiency
Fear a diagnosis of a mental health disorder may disqualify them from attaining permanent resident
status so they go untreated
Low socio-economic status
High utilizers of CVS Minute Clinics, ED and Kennesaw Urgent Care ($45/visit)
Feelings of isolation and identify issues from “culture clash”
Ser Familia identified only five Spanish-speaking mental health counselors in Cobb County
As children are “Americanized,” parents feel a loss of parental authority resulting in tension and family
dysfunction especially in homes where parents speak little to no English



Resource list
WellStar training in cultural proficiency related to domestic and family violence
Need culturally appropriate workshops on healthy lifestyles and prevent to be conducted in schools and
churches (doing these in “safe environments is the key”)
40
Community Listening Sessions – COBB COUNTY (Latino)*
Facilitated by a representative from the Hispanic Health Coalition of Georgia
*Summary of two Latino sessions at Iglesia de Dios (South Cobb) and McEachern UMC (West Cobb)
1.
2.
3.
4.
5.
6.
7.
8.
Poor nutrition
Tobacco use
Hypertension
Diabetes
Transportation
Lack of affordable and accessible healthcare
Access to dental care
Transportation














Cultural and language barriers hinder adaptation to healthy lifestyles
Lack of transportation, sidewalks and access to the gyms is prevents this community from exercising
Unhealthy habits such as tobacco use is due to youth trying to assimilate into culture
Low-income / unemployed can’t afford insurance
No prevention or management of chronic disease – see doctor but no follow-up
“Purchasing medicine is expensive” – it restricts or reduces availability of money for other costs like food
or transportation
No awareness of resources and services for better health (although both congregations are a part of the
WellStar Congregational Health Network)
The first barrier to health service is the cost. They want to go to the health checkup but health services
are too expensive, and the insurance is not seen like the answer because half of them don’t have access,
or despite its services are too expensive.
Community is aware about preventive services and when they recognize them like good services with
reasonable cost, they are willing to go for them paying and looking for them in any location.
WellStar is on mind of the community but like a hospital and medical center, not a System, and is mostly
related with expensive services.
Don’t know how to follow a healthy diet and lack time and motivation for physical activity – “doctors
recommend indications for a healthy life, but without questioning and considering culture and customs”
High ED utilization when they get sick - there is not education and resources there to help redirect them
Those with insurance noted the expense and prevent access “deductibles are high and unattainable and
services are expensive”
Good Sam is not easily accessible to get an appointment
41
Recommendations:





Utilize Latino faith-based congregations as a vehicle to educate and provide resources to the community
(pastors are considered leaders in their community)
Provide list of resources and health information in Spanish to help improve health knowledge and
accessibility to services
More options in neighborhood for physical activity and education to achieve a healthy lifestyle
Health Fairs (low cost or free) but with the availability of follow-up health services
Family counseling
.
42
Community Listening Session – DOUGLAS COUNTY (The CarePlace)









Lack of affordable healthcare, service and insurance
Substance abuse
Chronic disease – diabetes
Obesity
Mental health
Poor nutrition
Physical inactivity
Medication access
Transportation
 Low income, homeless – “We are not the sorry and lazy.”
 Unemployment/disability
 Free screenings without follow-up is useless (“What’s after?”)
 Poor diet and environment contribute to poor health
 “Obamacare…it’s terrible” – premiums increase and options decrease
 Nutritious food is the most expensive
 Hard to get access to specialty care
Recommendations:
 Outpatient services on a sliding scale
 Primary care and specialists need to volunteer at The CarePlace to “show somebody compassion” –
increasing care capacity
43
Community Listening Session – CHEROKEE COUNTY (Bethesda Community Clinic)











Diabetes
Mental health (depression)
Heart/stroke
Obesity
Poor nutrition
Physical inactivity
COPD
Lack of medical access for chronic disease (“30 day supply then go back to the ED”)
Lack of insurance (“We are in the wrong state.”)
Physical / family abuse
Prescription drug abuse









Lack of resources and education
Hard to get access to specialty care
Patients have developed personal relationships and trust and perceive it to be better care
Exercising is like “tying a weight around a person’s ankle and telling them to run a 50 yard dash”
Job loss is a defining moment (no money / homeless)
Mental health issues stem from circumstances / hopelessness
Importance of the spiritual side of a person for getting and staying well
Lack of awareness of preventative screenings – “We need to be educated about what we need and
when.”
Funds are limited from Georgia Charitable Care Network for services (60-90 days out)
Recommendations:




More engagement with Bethesda as they “help me with more than just medical stuff) education /
resources / referrals)
“Wellness coaching” education provided by WellStar onsite at clinic
Engagement of faith-based community (mentioned First Baptist Woodstock’s “Love Loud” initiative and
start with prevention via health educators
Men’s health is an area of improvement cited by Bethesda nurse manager
44
Community Listening Session – COBB COUNTY (Good Samaritan Health Center)
 Substance abuse
 Lack of affordable services and insurance
 Mental health
 Tobacco use
 Cancer
 Hypertension
 Diabetes
 Obesity
 Cardiovascular disease
 Transportation
 Poor nutrition
 Waiting list for Good Sam limits accessibility and addition of new patients
 Low income and education attainment (“You feel stuck.”)
 “Mental health resources don’t exist.”
 People want out of their neighborhood – drugs, violence – don’t feel safe to exercise, kids exposed to
drugs




Healthy habits are more expensive (food and gym memberships)

Distrust of system / State
Affordable dental care at Good Sam helps
Unemployment / underemployment
They feel trapped - If you don’t have a job or you make too much money you can’t get Obamacare. “You
decide whether or not you’re gonna eat or get the medicine.”
Recommendations:
 Need to add mental health services at Good Sam
 More providers to serve the community - “People are willing to pay according to their income.”
 Getting faith-based congregations to help fill transportation gaps (cited Milford Church Baptist)
 Resource list that’s up-to-date and distributed in community – media/radio
 Northwest Women’s health and WellStar screening mammogram referrals
45
Community Listening Session – PAULDING COUNTY (Paulding County Health Department)
 Lack of affordable healthcare and screenings
 Uninsured
 Transportation
 Poor nutrition
 Women and children’s health
 Lack of specialty care
 “We have to choose between a doctor visit or medicine.”
 A healthy lifestyle is too expensive (“Eating healthy costs a lot of money” and there’s “no safe place to
exercise.”)




Education – don’t know how to be healthy
Unemployment – low income prevents access to care
Paulding County Health Department doesn’t take appointments because of failure to show rates
Screening are unattainable because of cost
Recommendations:
 Need for more community clinics like Rapha in Temple, GA
 More preventative education – group, classroom setting
 Work with Warehouse of Hope (cited food bank)
 Expand Medicaid in Georgia
 Resources – no one knew about WellStar’s 770-956-STAR
 Need a women’s center at the new WellStar Paulding Hospital
46
RESEARCH TOOLS
GHPC KEY INFORMANT QUESTIONNAIRE CHNA
2015
Name: ____________________________________________________________
Title and Organization: _______________________________________________
Date of Interview: ___________________________________________________
CONTEXT
1. What in your opinion are the district’s/county’s/community’s biggest health issues or challenges that need
to be addressed?
2. What do you think are some of the root causes for these challenges?
3. How important an issue to the district/county/community is the reduction/elimination of health disparities?
What is your perception of current disparities?
4. How would you describe the present level of public/private partnerships that are occurring to improve
health and reduce health disparities in the county/community?
5. What are the challenges to beginning and sustaining such partnerships?
6. What specific programs and local resources have been used in the past to address health
improvement/disparity reduction?(might cite examples of programs by disease state, life stage or otherwise)
COMMUNITY CAPACITY
1. Who/What are some of key individuals/organizations/programs to health and health care in the
community?
2. Which community based organizations are best positioned to help improve the community’s health?
a. Private sector agencies
b. Public sector agencies
3. Are there individuals, agencies or organizations you’d like to see more engaged in your community’s health
improvement journey?
MOVING THE NEEDLE
1. If you could only pick 3 of these health issues, which are the most important ones to address either now
(short term) or later (long term)? What should be the focus of intervention by county/district/community?
2. Why did you pick these?
3. What interventions do you think will make a difference? Probe for different types of interventions related to:
a. Policy
b. Environment
47
c. Program
4. Do you have any other recommendations that you would make to the health system
(Kaiser/Piedmont/Grady/WellStar/Mercy Care) as they develop intervention strategies?
GHPC Focus Group Discussion Guide
WellStar Needs Assessment
Overview of Purpose of Discussion and Rules of a Focus Group
 Facilitator introduces self and thanks those in attendance for participating
 Facilitator explains purposes of discussion:
The project is being undertaken by Kaiser Permanente/ WellStar/Piedmont/Mercy Care. The health systems are
seeking ways to improve the health of residents in 34 counties in Georgia. They would like to hear from people
who live in these counties. They are particularly interested in your feelings about the health and health needs of
the community, how the health-related challenges might be addressed and what is already in place in your
community to help make change happen. More than just determining what the problems are, they want to hear
what solutions you all have to address the needs and what you would be willing to support in terms of new
initiatives or opportunities.
 Explain about focus groups:
 Give and take conversation
 I have questions I want to ask, but you will do most of the talking
 There are no right or wrong answers
 You are not expected to be an expert on health care, we just want your opinion and your
perspective as a member of this community
 You don't have to answer any questions you are uncomfortable answering
 It is important to speak one at a time because we are recording this conversation
 Your names will not be used when the tapes are transcribed, just male or female will appear on any
transcript
 I want to give everyone the opportunity to talk, so I may call on some of you who are quiet or ask
others to “hold on a minute” while I hear from someone else, so don’t take offense
 Here is an informed consent form for you to read along with me and then sign. (READ INFORMED
CONSENT, COLLECT SIGNATURES)
Participant Introductions
Please go around the table and introduce yourself and tell us how long you have lived in [this
county/community].
48
I am going to ask you all a series of questions about your own family’s health first, and then some questions
about what you see happening in your larger community related to health and wellbeing.
Thoughts on Health for Your Family and Community
1. What does the term “healthy lifestyle” mean to you?
2. Do you think you and your family have healthy lifestyles?
a. Why or why not? What affects your ability to be healthy? What prevents you from being as
healthy as you would like to be?
3. Do you think that most people in your community are healthy?
4. Do you think that there is something about your community that contributes to people having these types
of issues?
Healthy Behaviors
I want to go a bit deeper in a few areas related to your and your family’s health.
5. Let’s start with healthy eating. Most of the time, do you and your family eat as healthily as you would like?
a. What prevents you from eating healthily? (Probe for cultural issues, access to healthy food)
6. Now let’s talk about physical activity. What kinds of physical activity do you and your family engage in?
a. Do you think you get enough physical activity to be healthy?
7. What keeps you and your family from being as physically active as you would like to be?
a. What would help you and your family get more exercise?
8. If you could make 2 or 3 changes that would promote better health, what would they be?
9. How about tobacco use?
a. How prevalent is tobacco use among your family and friends? Do you think most people are
aware of the risks related to tobacco use? What do you think it would take to change people’s
habits when it comes to tobacco use?
10. Are drug and alcohol abuse a problem in your community?
a. What contributes to this problem? What could be done to address the problem?
11. Another health issue of concern is risky sexual behavior among teens.
a. Do you see this as prevalent in your community? Are there support services to help teens deal
with this type of issue?
12. When you think about the health concerns we have discussed –do you know of any
resources/programs/services in your community that help with these issues?
a. Are there different types of services that would be more appropriate or effective?
Health Outcomes and Access
13. Do you and your family have somewhere or someone that you go to for routine medical care?
a. When you go there, does anyone ever talk to you or provide you with information about the
health issues we have been discussing – weight, exercise, healthy eating, tobacco, drug and
alcohol use, sexual behavior? Do you think your primary care provider should ask you about
these issues? Provide you with information? Help you to change your habits?
Facilitator: Present community-appropriate data summary to participants.
49
14. What is your reaction to this information?
a. Does it ring true to what you know about your community? Is there anything missing from these
data that you believe to be true about your community?
15. What do you think is the best/most effective way to begin to address these issues?
16. What do you see as the role of the hospital or health system to address these issues?
17. Considering the information that I just presented to you, along with your own experience with critical health
needs here, which 1 or 2 of these health issues should be the priorities for addressing over the next three
years?
Health Concerns in the Community
18. Now let’s talk about what about your community. Please tell me about the strengths/positives in your
community.
19. In communities, people often talk about community leaders- these are organizations or individuals that
everyone knows, places/people that you seek out when you need information that is trusted. Do you know
of these types of organizations or people who are concerned about health issues and serve as leaders in
trying to improve health in your community?
a. Who are they – what are they doing? Are their efforts successful? Why or why not?
20. Would these organizations or people be good leaders for addressing other health issues in the
community?
a. If not them, then who?
21. What should be done to ensure that children in your community finish their education and can find jobs?
Closing:
22. How would you like your community to be different in 5 years in order to be a healthier place for you and
your family to live?
#
#
#
50
Community Health Needs – KEY INFORMANT SURVEY
Thank you for assisting WellStar Health System with its upcoming Community Health Needs
Assessment (CHNA) research. Your expertise and insight is valued and appreciated.
NAME
SURVEY DATE
ORGANIZATION/
AFFILIATION:
TITLE:
ZIP CODE OF
AFFILIATED ORG.:
COUNTY: Circle one:
Bartow
Cherokee
Cobb
Douglas
Paulding
Other:__________
We
are
required
to
list
the
organization/affiliation
of
the
key
informants
we
survey in our CHNA
PERMISSION TO
report
to
be
published
online
at
wellstar.org
by
June
30,
2016.
Your
personal
information will not
LIST YOUR
Please circle or highlight your selection.
PARTICIPATION IN be published.
CHNA REPORT?
YES, I grant permission to list my organization/affiliation / NO
1. How would you rate health and quality of life in the county you live? (Circle or highlight your
selection.)
Very Good
Good
Fair
Poor
Very Poor
2. In your opinion, over the past three years, has health and quality of life in your county:
(Circle or highlight your selection.)
Improved
Stayed the same
Declined
Don’t know
Please explain why you think the health and quality of life in the County has improved, stayed
the same, or declined and any factors informing your answer.
51
3. Please list the people or groups of people in your county whose health or quality of life may
not be as good as others. Why? Please note any zips / areas where there are health
disparities/pockets of poverty.
4. What barriers, if any, exist to improving health and quality of life in the county?
5. In your opinion, what are the most critical health problems?
6. What needs to be done to address these issues?
7. There are unhealthy behaviors that have the largest impact on the health and safety of the
community as a whole. Pick the top 5 unhealthy behaviors you deem have the largest impact
on your community:
Alcohol abuse
Illegal drug abuse
Unsafe sex
Lack of exercise
Not getting immunizations
Not using seat belts
Not going to the dentist
Not going to the doctor for check-ups / screenings
Not getting prenatal care
Not washing hands
Poor eating habits
Drunk driving
Smoking / tobacco use
Suicide
Violent behavior
OTHER:______________________________________________________________________________
8. What actions, policy or funding priorities would you support because they would contribute
to a healthier county? Please be specific.
9. In your opinion, what else will improve health and quality of life in the county?
52
10. Please name at least one program or community change that has positively impacted the
health of the people you serve or the population of your county in general over the last three
years. What differentiated it from other programs designed to improve access to care and
overall health? Why did it work? (If you have supporting materials or a website link, please
share.)
11. Where does your community get most of their health-related information? Choose up to 3 by
circling or highlighting.
Friends and family
Doctor/nurse/pharmacist
Internet
Public Health Department
Television
Hospital
Help lines (telephone)
Books/magazines
Free Care Clinic
Social media
School
Congregation
Newspaper
Other:__________________________
12. What do you think are the top issues that have the largest impact on quality of life in your
community? Pick up to 5 by circling or highlighting.
Animal control
Availability of child care
Affordability of health services
Availability of healthy food choices
Bioterrorism
Dropping out of school
Homelessness
Lack of law enforcement
Literacy
Secondhand smoke
Work safety
Availability of healthy family activities
Availability of positive teen activities
Neglect and abuse
Elder ___ Child ___
Inadequate / unaffordable housing
Lack of / inadequate health insurance
Lack of culturally appropriate health services
Lack of health providers
What kind?_______________
Pollution (water, air, land)
Low income / poverty
Racism
Lack of transportation options
Mental health issues
Lack of recreational facilities
Unhealthy / unsafe home conditions
Rape / sexual assault
Domestic violence
Youth crime
Unemployment
Unsafe, unmaintained roads
Violent crime
Gang issues
Others: ________________________
53
13. Is there anything we left out of this survey that we need to know about the most pressing
health needs of the community you serve?
14. In your opinion, how could WellStar Health System improve its access, education, programs,
and outreach to the communities it serves, especially the most vulnerable?
15. In your opinion, what organization/agency/clinic/health system is best taking care of the
health needs of vulnerable populations? What makes them effective?
Would you like us to contact you to further discuss topics in this survey?
Yes
/
No
If yes, what is the best method to contact you?
Thank you for your time!
Other comments:
54
Community Health Needs Assessment 2016
Listening Session GUIDE
Equipment and Supplies
 Focus group guide and surveys
 Tape recorder or other recording device
 Name tags or tent cards
 Legal pad and 10-12 pens or pencils for notes (assistant)
 Sign in sheet for participants (optional) – can double as informed consent form
 Manila envelope for completed surveys
 Copies of surveys – pre-placed with pens at table ***Encourage participants to begin completing
survey upon arrival***
AT START TIME:
Overview of Purpose of Discussion and Rules of a Focus Group
 Facilitator introduces self and thanks those in attendance for participating
 Facilitator explains purposes of discussion:
The project is being undertaken by WellStar Health System. WellStar is seeking ways to improve the health of
residents in five counties in Georgia and want to hear from you. They are particularly interested in your feelings
about the health and health needs of the community, how the health-related challenges might be addressed and
what is already in place in your community to help make change happen. More than just determining what the
problems are, they want to hear what solutions you all have to address the needs and what you would be willing
to support in terms of new initiatives or opportunities.
Information gathered will help determine:
 Current community practices for maintaining health
 Kinds of health problems that you think occur most often in your community
 Barriers people have to good health
 Community ideas for solutions to health problems
 Identification of groups of people underserved for health needs
Explain about focus groups:
 Give and take conversation
 I have questions I want to ask, but you will do most of the talking
 There are no right or wrong answers
 You are not expected to be an expert on health care, we just want your opinion and your perspective as
a member of this community
 You don't have to answer any questions you are uncomfortable answering
 It is important to speak one at a time because we are recording this conversation (and taking notes)
55


Your names will not be used
I want to give everyone the opportunity to talk, so I may call on some of you who are quiet or ask others
to “hold on a minute” while I hear from someone else, so don’t take offense
Here is an informed consent form for you to read along with me and then sign. (INFORMED CONSENT, COLLECT
SIGNATURES)
Participant Introductions
1. Please go around the table and tell me your name, how long you have lived in [this county/community]
and the best thing about living in this county/community.
I am going to ask you all a series of questions about health. This discussion time will be capped at 1.5 hours.
Introductory Question:
1. Where do you go to get information about health?
Prompts: Resources? Providers? Internet?
2. In this group’s opinion, what are the serious health problems in your family and community? What
are some causes of these problems?
Prompts: What about physical health problems? What about social problems that affect health (like violence,
substance abuse, etc.) What about mental health problems?
Facilitator: Probe for causes for each health problem identified right after it is mentioned.
3. What keeps you and other people in your community from being healthy?
Facilitator: You are helping to elicit participants’ views of barriers and challenges that prevent them from
maintaining good health and accessing healthcare services.
Prompts: What about costs of medical visits? Medicine? Health insurance? Other types of health services like
mammograms and other screenings?
Facilitator: Before asking this question, summarize what you heard in question #3 to help the group focus on
their discussion of solutions in this question:
4.
What could be done to solve these problems?
5. In your opinion, who are the people not receiving enough health care or access to care? Why not?
Facilitator: This question allows participants to share their views of possible solutions to the health problems,
their causes and barriers that they have discussed in previous questions.
6. Is there anything you would like to add or you think would be helpful for us to know?
56
Facilitator: Thank you for participating. Your responses will be summarized along with those of other
community groups. The results will be shared publicly in WellStar’s Community Health Needs Assessment
report to be on their website by summer 2016. This information helps determine the most important health
issues in your county.
57
Please note:
SOME COMMUNITY RESPONSES MAY NOT REFLECT THE OPINION OR PRIORITIES OF WELLSTAR.
2016 Key Informant Survey Input – WellStar procured
County
Bartow
2
Cherokee
4
Cobb
31
Douglas
6
Paulding
10
Zip
30121
30102
30114
30188
30115 1
30157
30168
30122
30135
30134 1
30141 1
30132 111111
30101 1
Sectors
Health District
Safety net –
resource center
School System
County Health
Department
Department of
Family &
Children
Services
Safety net
community
clinic
30064 1
30217
30168
30062 1
30144 111
30080 1
30060 1111
30339
30068
30090 1
30008 11
30303,30008,30060,
30101, 30064, 30127
30127
30152
30066
30061
Senior Services
Austell Community
Taskforce
WHS Board Member
Small business
Fire
Police
Chamber
Finance
Community member
Hispanic Health
Public Services
Agency
CHOA
Public Health
FQHC
Children’s Advocacy
Higher education
ACS
ACS – Marietta
Health Dept.
Small business
County government
School system
Drug prevention
Emergency
services
Community
clinic
Business
Hospital board
School System
Non-profit
organization for
family and
children
Regional
Hospital Board
Business (bail)
Non-profit
Community
clinic advocates
Health System
Law
enforcement
Hispanic nonprofit
County Health
Department
County
government
58
How would
you rate the
health and
quality of
life in the
county you
live?
In the past
three years,
has the
health and
quality…
Very good
Very good
Good 1
Good 11
organization
Mental Health
Health System
Faith-based resource
center
Very good
1111111111
Very good
Very good 1
Good 11111
Good 11111
Fair 1
Fair 111
Fair
Fair 1
Good
11111111111111111
Poor
Poor
Fair 11
Poor
Poor 1
Very Poor 1
Very Poor
Poor 1
Very Poor
Very Poor
Improved
Improved 11
Very Poor
Improved
111111111111111
Improved 11
Improved
11111
Stayed the same
1
Stayed the same
1
Declined 1
Declined
Stayed the same
11111111
Stayed the
same 1111
Declined
Declined 11111
Don’t Know
Don’t Know
Declined 1
Don’t Know
Don’t Know 111
Please
explain why
you think
the health
and quality
of life has
improved,
stayed the
same or
declined
and any
factors
informing
your
answer.
Higher demand
for services and
at our free clinic.
With economic
downturn, many
people can’t
afford ACA – If
do, no providers
accept.
Medicare
reimbursements
down and no
longer accepts
Medicaid.
Very few
resources in the
area until now.
Our facility is the
first for residents
in South Bartow.
In Cherokee
County, the
addition of
community
clinics has
prepared to
serve the less
fortunate and
improved
children’s
health, resulting
in a faster return
to school time
for children who
are sick. The
community
clinic also offers
gift cards for
free office visits
for anyone in
need. At times
there is access
Stayed the same
11
It looks like Cobb
Douglas fairs better
than the state of GA.
Cobb also has a
higher median
income that most
counties.
According to CDPH’s
2014 Annual Report,
Cobb County
population continues
to grow (4.5 percent
from 2009-2013) and
cardiovascular
disease is the
number one cause of
death in adults
(2008-2012) even
though the death
rate is lower than the
state. Cobb fairs
Don’t Know 1
More
accessibility and
more services
and awareness
of those
services.
People are still
lacking access
necessary to
manage chronic
conditions such
as COPD,
hypertension
and diabetes.
No real visible
public efforts
that the citizens
participate in
consistently.
Access to
specialized and
emergency care
have improved
due to opening
new hospital
more centrally
located, with
more specialists
and expanded
emergency
services.
New Paulding
Hospital added
great benefit
and shopping
and recreational
opportunities
are bountiful.
Declined due to
59
to free
medication such
as lice shampoo.
Also expanded
hospital services
in the near
future – new
Northside
Cherokee,
WellStar Health
System and
CHOA Urgent
Care locating to
Cherokee
County.
An increase in
medical
facilities,
healthcare
providers and
economic
growth.
I think many
people were
hopeful that
there would be
improvements
with the new
Affordable Care
Plans, however
we have found
that many
people are
returning to the
clinic because
they can no
longer afford
the insurance
plan, cannot
find a provider
that will take
the insurance or
give up due to
frustration from
trying to
navigate the
betters with several
health indicators
(obesity, smoking,
infant mortality,
prevalence of
diabetes, asthma)
however within
those health
disparities exist.
More sites available.
More services for
children using
appropriate size
instruments. More
updates to facilities.
Declined because a
hospital was closed
and remains vacant.
This action results in
a shrinkage of care.
There are more
health facilities
within a reasonable
travel distance at a
reasonable price.
A dedicated focused
attention on health
and wellness. The
Chamber’s
involvement –
public-private
partnerships and the
Cobb2020 work.
Stayed the same
even though
meds/txs/procedures
have improved
because we continue
to suffer from longterm unhealthy
issues like obesity.
Kennestone is now a
Stayed the
same – A major
issue that is
about the same
is the access to
primary care
physicians.
Douglas does
not have
sufficient
primary care
physicians
which cause an
overuse of
Emergency
Rooms and a
strain on the
only free clinic
the CarePlace.
This has been
an ongoing
problem for
many years.
Not much has
changed.
the lack of jobs
for manual
labor and lack of
insurance.
New hospital
services in our
community.
Stayed the same
– no data that
indicates
improvement at
this time.
As we develop
the Paulding
Community
Health &
Resource Center
into a charitable
healthcare clinic
and one-stop
community
services center,
I have talked
with many
people around
the community
who agree that
the uninsured
and
underinsured
are in much
greater need of
health care:
medical, dental,
behavioral and
nutritional. My
conclusion is
that the health
and quality of
life is adequate
in the
community, but
will be made
much better
and be made
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insurance,
Medicaid, VA,
and hospital
systems. There
is also a large
Hispanic
population in
Cherokee
County who
cannot obtain
specialty care
unless they pay
cash in the
system if they
are not
documented.
Level 2 trauma
center and provides
better access to
medical care.
Numerous parks are
situated throughout
the county for
exercise. Police and
Fire are outstanding
and provide rapid
response to issues.
I think the county is
working to increase
health parks, trails,
health awareness
and education, but I
think due to the fact
that we are eating
more and moving
less it has not made
much of a difference.
Kennestone has
continued to expand
its campus and has
added valuable
medical services such
as a special Pediatric
facility. Additionally
the WellStar system
has added two
medical campuses
off the main campus
in East Cobb and
North Cobb. This
expansion makes it
more convenient to
residences living in
those areas of the
county to receive
medical tests,
imaging and
physician services
without traveling to
the main campuses
of WellStar.
While residents of
more
widespread
with the
opening of a
charitable
healthcare
clinic. In
addition, a onestop services
center
associated with
the clinic and
under the same
corporate entity
will also aid in
the betterment
of the residents
by providing
more
convenient
access to
government
agencies, as well
as providing
easier access to
aid
organizations.
Improved
because of the
new Paulding
Hospital.
Improved – I
think that with
the new
hospital it has
opened more
opportunities
for quality
services not
available at the
old facility.
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certain areas of Cobb
enjoy disposable
income that allows
them to access foods
conducive to healthy
lifestyles, as well as
safe neighborhoods
to play and exercise
and access
healthcare, many
parts of Cobb do not
enjoy those same
qualities of life.
There are food
deserts in Cobb that
have not been
addressed.
I have been a
resident and worked
in Cobb County for
the last 10 years.
Ultimately, I see the
overall health and
quality of life in the
county has stayed
the same. Pockets
see improvement,
but the general
overall county seems
to stay the same. I’ve
moved from South
Cobb, where
community
resources and
support are needed
to now living in
northwest Cobb
County where
resources are
plentiful and
growing.
Health and quality of
life has declined in
Cobb County
because of Obama
Care, in my opinion.
Many who are
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required to pay for
insurance don’t have
it because they can’t
afford it.
Improved b/c added
facilities by WellStar
and continued
upgrades along with
constant influxes of
quality caregivers
have caused our
communities overall
healthcare to
improve.
Improved – There
are in increase in
activities promoting
healthy lifestyles
including: additional
walking trails,
addition of sidewalks
to promote more
walking, additional
5k and other exercise
sponsored events
including the Walk
GA/Cobb 2020
initiative. In addition
the local farmer’s
market and
community grocery
stores seem to offer
more options of
seasonal fresh fruits
and vegetables.
Improved - The
major reasons are:
economy has
improved so healthy
food choices are
available; efforts to
have more
fruits/vegetables in
school cafeterias;
fewer teen
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pregnancies;
reduction in smoking
by young folks;
nonprofit
organizations in
Cobb dedicated to
improving the
welfare of its citizens
(MUST, Cobb
Resource Center);
more men getting
prostate testing;
emphasis on good
prenatal care; more
emphasis on moving
about (exercise) vs
sitting; and, more
stress reduction
opportunities in the
work place.
Declined – due to the
number of citizens
who have become
addicted to
opioids/heroin. In
2014, we had 56
overdose deaths
directly related to
heroin alone, most of
whom were young
adults.
Improved – Overall
expansion of care
sites in county.
Stayed the same –
with the advent of
the ACA, which was
supposed to improve
access, we continue
to see the same
amount of
uninsured, placing
the burden of
healthcare on our
health system to care
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for everyone.
Improved – More
education has been
provided to many
and people are more
health conscious companies providing
fit bits, fitness
centers, etc.
Declined – 1) Rates
of obesity 2) Rise of
suburban poverty
since 2008 3) Gap of
healthcare coverage
BARTOW
16. Please list the people or groups of people in your county whose health or quality of life may not be as
good as others. Why? Please note any zips / areas where there are health disparities/pockets of
poverty.
Emerson/Allatoona ES – 30101, 30137
Poorest population in Adairsville – 30103
30137 and 30102 are the primary zip codes and the overall quality of life and health are very bad due to
high unemployment, drug use, poverty, and crime.
Declined – need coverage and can’t access care. Demands exceeds supply. Cartersville Medical Center
is a for profit hospital – accept patients to a limit. Screen patients, but if you find something – then
what? Biggest areas of concern at diabetes, hypertension meds – Publix offers free antibiotics, but
people are not aware. People can’t afford medications and insulin for diabetics. Can we get expired
meds?
Little to no access to resources, employment opportunities, healthcare and transportation.
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18. In your opinion, what are the most critical health problems and > what needs to be done to address
these issues?
Obesity. Heart disease and stroke in Bartow is high. Cancer – breast cancer Medicaid and cervical
cancer screening (gap in cancer – lung cancer screening. High smoking area. Diabetes. Dental – hardest
need to meet. > Primary prevention through education and access to healthcare and men’s health
information
We pay nurses less. Funding down in health department.
Poor eating, drug use > access to nutrition education, employment efforts to better provide,
transportation.
community as a whole. Pick the top 5 unhealthy behaviors you deem have the largest impact on your
community:
Alcohol abuse
11
Illegal drug abuse
11
Unsafe sex
1
Lack of exercise
1
Not washing hands
Poor eating habits
1
Drunk driving
11
Suicide
Violent behavior
OTHER:________co-sleeping – child fatality rate higher – lower economic – trying to educate
20. What actions, policy or funding priorities would you support because they would contribute to a
healthier county? Please be specific.
Real affordable and accessible healthcare
If we screen, then follow-up process
Need a PAP to get meds to people in need
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Nutrition education. Clinic access. Dental assistance programs. Prescription medication assistance.
Public health – prevention focused but you must take on the basic needs – get people well first
Employment opportunities. Youth programs.
22. Please name at least one program or community change that has positively impacted the health of
the people you serve or the population of your county in general over the last three years. What
differentiated it from other programs designed to improve access to care and overall health? Why
did it work? (If you have supporting materials or a website link, please share.
Bartow Health Access
Allatoona Resource Center – we have just begun serving the residents of South Bartow in just the last
four months. We are providing educational opportunities, employment opportunities as well as
assistance programs to residents. We also have a gym facility on-site providing youth programs and
recreation.
23. Where does your community get most of their health-related information? Choose up to 3 by circling
or highlighting.
Friends and family
Internet
1
1
Television
Hospital
1
Books/magazines
Free Care Clinic
Social media
1
School
1
Congregation
1
Newspaper
Other:__________________________
24. What do you think are the top issues that have the largest impact on quality of life in your
Animal control
Literacy
Secondhand smoke
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11
Bioterrorism
1
Homelessness
1
1
What kind?_______________
1 (overwhelmed – trying to revive) 1
1
Domestic violence
Youth crime
1
Work safety
1
1
Neglect and abuse
Elder ___ Child ___
1
Racism
1 (takes a 24 hour notice for Bartow Transit no bus
system elderly cost $1.50 each way) 1
Unemployment
1
Violent crime
Gang issues
Others: _______working poor_________________
25. Is there anything we left out of this survey that we need to know about the most pressing health
needs of the community you serve?
We need to pull people together to provide quality healthcare and engage faith-based community.
Trinity (church) feeds a lot of people.
26. In your opinion, how could WellStar Health System improve its access, education, programs, and
outreach to the communities it serves, especially the most vulnerable?
Work and volunteer – Pay for NP, Hep-C medication.
By providing programs in our specific area as transportation is such an issue.
27. In your opinion, what organization/agency/clinic/health system is best taking care of the health
needs of vulnerable populations? What makes them effective?
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No one – we’re not meeting the needs.
Not sure.
CHEROKEE
poverty.
There continues to be a lack of wellness/preventative medical care such as vaccinations among the
Hispanic population. Fear of being sent back to one’s home country interferes with the willingness to
seek medical care. Also, the communication gap is an obstacle in providing information to parents with
children who have medical needs such as diabetes. Maintaining an understanding of what nurses need
to care for their children at school is frustrating.
Populations with insufficient transportation. Uninsured population . Underinsured. Population who lack
access to the health system. Low socio-economic status.
Low-income families, specifically River Ridge and Bells Ferry area (30114/30189)
The zip codes Bethesda serves are predominantly 30114, 30115, 30188, 30189, 30102. 40 percent of
the population is Hispanic. We discover that many of them have diabetes when they come in for a visit
and are unaware. We feel a lot of this is dietary, funding to purchase food, lack of health/nutrition
education, language barrier and access to care due to non-citizenship and transportation. We are also
seeing an increasing number of clients with hypertension and depression/anxiety.
Transportation, lack of dental care for the uninsured, decreased staffing at the local health department,
communication differences, lack of basic supplies such as soap, water, toothbrush, thermometers at
home are all barriers that exist and contribute to the quality of life in Cherokee County.
Need sufficient transportation. Deficient in insurance and/or insurance coverage. Mental healthcare at
no or low cost.
Limited resources. Resources low income families cannot afford. Unknown resources that need more
exposure.
Access to affordable, primary and specialty care for those that do not have insurance or for those that
have insurance but cannot afford the deductibles. A way to route follow-up care from ER to clinic can
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help decrease ER costs and assist patient in continuity of care, maintain their medication, begin
education for success. Access to affordable mental healthcare and counseling. Health education.
Social Work Network for clinics to help clients access PeachCare for their children, food stamps,
employment services (all the way in Marietta), mental health services, counseling, etc. Transportation.
these issues?
Children born with fragile medical needs such as respiratory/heart issues that require one/one nursing
services, medical equipment at home and at school. Some families do not realize resources are
available by filling out proper paperwork or contacting agencies that can help > Someone to facilitate
the paperwork process from hospital to home to school.
Substance abuse. Hypertension/diabetes. Obesity. Lack of physical activity. Teen pregnancy.
Resources for cancer care > Solutions for substance abuse (support of Drug-Free Cherokee). Increase
options for population to receive low or no cost case for all health issues – primary care, prevention
care, wellness, cancer, chronic illness, and dental care.
Extreme mental health issues. Chronic substance abuse. Teen suicide. > Increased community
resources on a sliding scale fee or acceptance of Medicaid. Increased awareness.
Diabetes, HTN, mental health, dental health, cardiac/neuro, GI, asthma/COPD (need for smoking
cessation – meds too costly) > collaboration between clinics, hospitals, physicians, dentists, social
workers to fill these gaps and do what is right in your heart.
community:
Alcohol abuse
1
Illegal drug abuse
111
111
Unsafe sex
1
Lack of exercise
1
1
Not washing hands
1
Poor eating habits
1
Drunk driving
1
11
70
1
Suicide
111
Violent behavior
1
OTHER:______________________________________________________________________________
A special center within Cherokee to house medically fragile students. All needs could be met under one
roof – educational, medical, therapeutic services.
A designated place to go for dental/eye care services.
Transportation to health resources. Open access clinics that the community can benefit with services in
all areas of health (prevention, acute care and chronic disease)
Teen suicide rate initiatives increasing as the rate is extremely high in Cherokee County. Local substance
abuse treatment options.
Diabetes prevention/education program. Cardiac health education program (to include HTN,
cholesterol, exercise program). Mental health program (to include opportunities for resources,
education, counseling). Tobacco cessation. Dental health. ***It’s important to start as a child – let’s
do something with children and teach them along with their parents. Adults will learn through the eyes
of their child. There are health programs in the school but not with the parents.
Healthy lifestyle awareness/preventative care.
Funding.
A community of hope that embraces the identified citizens in need and works together to address the
unhealthy behaviors from a preventive and treatment/support perspective. We need to collaborate to
increase the support network for low income families.
This may seem simple but it is… It’s the simple act of caring and showing it to one another. A smile,
patience, a kind word and a moment of your time can go a long way.
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7.
Please name at least one program or community change that has positively impacted the health of
did it work? (If you have supporting materials or a website link, please share.)
School nurses on every school campus. It has helped because the school nurse is sometimes the first
line of medical care a child receives.
Cherokee Focus – The Family Connection Grant and community efforts with a strong, collaborative
group which supports a healthy county. Groups meet monthly to share resources and connect the
needs of the community with the available resources.
Access to numerous healthcare services that are free or on a sliding scale for low income families:
Bethesda Community Clinic.
Here are two because we need them to work together: 1. We partnered with WellStar a couple years
ago which allowed us to assist our patients with free labs/imaging who would not be able to afford it
otherwise. This has helped our patients tremendously. By doing this, our patient are able to return,
keep a check on their labs who have DM, HTN, high cholesterol, etc. and then educate and adjust
medication as needed. Through the imaging services, we have been able to help many who would have
otherwise may have not been diagnosed with mammography, others who we found needed surgery,
etc. I remember one case of a patient who needed imaging. If he had not gone that day and then be
sent to the ER by us (he would not go to the ER due to cost even though in pain) his appendix would
have ruptured.
2. Kaiser – Assist us with some specialty referrals at no cost. Without these, our
patients who we find need specialty services would not receive it due to the increased cost of the
physician services. The labs and imaging are utilized to help us determine this need.
or highlighting.
Friends and family
11
11
Internet
1
1
Television
1
Hospital
Books/magazines
Free Care Clinic
11
Social media
School
Congregation
Newspaper
Other:__________________________
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9.
What do you think are the top issues that have the largest impact on quality of life in your
Animal control
111
1
Bioterrorism
Homelessness
1
1
1
1
11
What kind? Dental / chronic disease and primary care
11
Domestic violence
Youth crime
Literacy
Secondhand smoke
Work safety
Neglect and abuse
1
Elder ___ Child 11
1
Racism
1
Unemployment
Violent crime
Gang issues
Others: ________________Substance abuse________
This county has been an unfortunate leader in substance abuse – heroin. The community at large is
mainly unaware of this information except of law enforcement.
Reaching out to those who need care, preventative or acute.
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Availability of access to care and education to those cited groups.
Sliding scale education and services related to low income families; in-home services.
Incorporate and maintain programs discussed in #5-8 in Cherokee County in partnership with clinics,
schools and churches in the community.
Children’s Hospital and urgent cares (CHOA), Bethesda Community Clinic, Schools, volunteer
organizations such as Cherokee County Service League.
Representing Public Health, based on funding, a good deal of education, prevention and care takes place
at the health department. There are limited programs, staffing, etc. however the public looks to the
Health Department first many times before seeking care elsewhere.
The Health Department. Sliding scale community services with tracking and follow-up, and some inhome services. Bethesda Community Clinic.
I think every health system does what they can but by partnering together with the local clinics we can
do so much more. I believe we are the only clinic open every day in Cherokee County and do what we
can with the limited resources that we have been blessed with just like everyone else.
COBB
poverty.
Black/African American, Hispanic, low-income older adults due to decreasing housing options, lack of
affordable housing, no emergency housing/shelter that is senior friendly in Cobb County. In CD Health
District, higher percentage of Blacks reported heart attacks compared to state average (6.0% compared
to 3.1% in Georgia, 2011) Lack of access to affordable healthcare, housing and transportation. Lack of
volunteers to deliver meals.
30008 Marietta
30060 Marietta (designated S of Dallas Hwy. or Lower Roswell Road)
30064 Marietta (designate S of Dallas Hwy.)
30067 Marietta (designate S of Dallas Hwy. or Lower Roswell Road)
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30080 Smyrna
30082 Smyrna
30106 Austell
30126 Mableton
30127 Powder Springs
30168 Austell – working class families unable to afford preventative medicine and healthy options
30339 Atlanta (designate S of Dallas Hwy)
Elderly needing skilled nursing – not enough beds. Cost-prohibitive to many.
Low-income housing complexes such as in and around Franklin Road
South Cobb – Austell – Food deserts.
Low-income areas where access to healthcare continues to be a problem.
I believe the area of South Cobb may have health disparities. There are no health parks that I am aware
of in the south Cobb area like the one in Acworth and East Cobb. I don’t travel the south Cobb area very
frequently so I can’t be sure about the health parks.
Obviously, lower income families are hit the hardest. Limited access to healthcare, preventative care
and poor diet are factors.
Austell/Powder Springs, pockets of Smyrna – communities of LaBelle ES, Belmont Hill ES and Green
Acres ES
As in most regions, the most visible pockets of health disparities track the areas where the population is
most vulnerable, those with a significant numbers of individuals and families at or below poverty level,
low educational level, mixed ethnicity, limited English proficiency and poor health literacy. These areas
also mirror the known areas where there are large under-insured or uninsured persons. These are areas
of food scarcity/food deserts and tend environmental insecurities. These are the pockets of the WHS
catchment areas that are neither desirable nor profitable yet were a significant proportion of our
patients reside. They are made up of the areas covered by the Zip codes: 30080, 30082, 30069, 30180,
30067, 30134, 30114, and 30143. The transient nature of these population groups creates a fluid
situation that cannot be precisely defined.
Those disparate communities throughout Cobb County – particularly those of minority communities –
East and South Cobb areas. In addition, the elderly population is often forgotten or omitted in the
collection of data as it relates to overall health and quality of life (affordable housing, accessible and
available modes of transportation)
Fresh food deserts – southwest Cobb, small pockets of Kennesaw, Marietta, Powder Springs
75
Franklin Road area. South Cobb/Mableton, Far north Cobb area
People without insurance
People who are 300% of below the federal poverty level (yes 300, not just 200)
All the census tracts as Cobb’s only official Medical Underserved Area and Health Professional shortage
areas. (Good Sam Cobb sits in the middle of this.)
Zip codes include 30008 and areas of town associated with the following:
Fair Oaks, Osbourne High school and neighborhoods in its feeder schools, Austell, 6 Flags area,
Mableton, (pretty much all of south or southwest cobb), Pebble Brook High school and its surrounding
feeder schools
There is not enough affordable access to medical or dental care in these areas. Transportation is also a
barrier to reach other parts of the Atlanta metro area where additional services may be located.
Children and the elderly. They have to rely on others in order to ensure their quality of life is good.
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College student-living on limited income and resources.
Some students are homeless.
Students that are veterans.
Zip Code: 30144
The communities of focus for our disparities work for the American Cancer Society in Cobb County are:
Powder Springs/Mableton/Austell area (South Cobb)
Windy Hill Road area of Marietta/Smyrna – high concentration of Hispanic outreach in this area.
Work needs to be culturally sensitive and bilingual. Focus on women’s health and screenings is
important.
76
The African American and Hispanic populations are those groups whose health and quality of life is not
as good as others. I believe it’s because of lack of education, access to services, transportation and
resources such as money. Zips included are 30008, 30060, 30027.
Those that are under insured or uninsured; uneducated about health needs; afraid or unaware of health
care availability
Elderly and minorities around Mableton and Austell.
Osborne H.S. Feeder Area communities particularly off Austell road between Windy Hill and South Cobb
Drive
Old Mableton communities off Mableton Parkway, and off Veterans Memorial between Cooper Lake
and the City of Austell City limits
City of Austell
Some Powder Springs communities off Hopkins Road and Forest Hill
Unincorporated off Austell in 30168
Pebblebrook High School Community off between South Gordon, Cardell, and Veterans Memorial.
While physical activity and healthy eating is being encouraged those in the lower socio-economic areas
and the elderly still struggle to improve due to expense, lack of transportation and mindset. Changes
take time.
Major pockets in the South Cobb Community and Marietta are still experiencing a disproportionate
amount of high risk factors which contribute to a lower quality of life. Some areas of 30168, 30126 ,
30060 (trailer parks on Sandtown Road); the Riverside area; the Fairground area; and, the old Franklin
Rd corridor appear to experience a lower quality of life than other parts of the county.
Data suggests African- American and Hispanics seem to experience a larger number of unhealthy
indicators. The major reasons are: food selections; lack of exercise, limited visits to medical care;
limited preventative care; lack of sleep; poor socialization; high stress; high levels of crime in some
communities; a culture of violence; high cost of housing in Cobb; discrimination; high dissolutions of
families; underemployment; unemployment; apathy, drug usage; and alcohol abuse.
In particular, the young adults ages 18-36 are experiencing the highest number of overdose and death
directly related to opioids/heroin. Of the 56 deaths due to heroin in 2014, 55% were white male, 29%
white females, 47% were in their 20s and 22% in their 30s. So in conclusion, the group of white young
adults may not have the best quality of life regarding health.
Lower socio-economic classes continue to be challenged with access and resources. These pockets exist
throughout the county with concentrations in the Dobbins area, Campbell/Osborne HS area,
Pebblebrook HS area for example.
The poor, the uninsured and the marginalized within our society.
77
Areas that are in food deserts. Low-income areas.
1)
Food deserts in South Cobb – limited access to heathy nutrition options.
2)
Informative: the gap between “cheap” fatty foods and more expensive “healthy foods” from a
cost standpoint is closing, but still dissimilar.
3)
The rates of poverty have increased dramatically in Cobb – example – number of children
receiving free/reduced lunch has increased from 35K just 4-5 years ago to over 50K today.
4)
While a great place to live, Cobb is not an inexpensive place to live. Mortgage and rent
payments as percentage of income are higher in Cobb – roughly 15-20 percent than the State of Georgia
– meaning families have less monthly income dollars to allocate beyond housing.
Senior citizens and minorities.
Political will fix transportation, lack of walkable/bicycle friendly communities, support systems or
infrastructure for aging in place.
Cost to patients. Coordination among providers.
Vending machines loaded with junk items – no salt-free options.
Some facilities are not accessible by public transportation.
Perceptions – people don’t think their lifestyle choices affect their health.
Access to healthcare to those not insured.
Access to good medical care. Rising deductibles in most insurance policies make it difficult for many
people to pay. People wait until they are very ill before going the doctor because of the costs. Also,
some prescription medications are not affordable to many people who are in need across the country. I
don’t believe this is necessarily true in the Cobb county area, but probably true in parts of the country.
Desk jobs/sitting all day. Commute time. Businesses that do not promote wellness.
I’m concerned about the number of people that come to the emergency rooms at WellStar that simply
need to see a physician for what I consider a minor illness. Is there any opportunity to have a facility to
treat that type patient separate from those with medical emergencies that are not transported by
ambulance?
Money is the primary barrier. Money allows a higher quality of housing which can lead to better indoor
air quality as well as feeling of safety about being outside to exercise and play. It also allows individuals
to purchase healthcare insurance that affords options. As well as transportation to easily go to the
78
doctors’ appointments and other healthcare appointments. Higher disposable income allows access to
stores that offer a variety of fresh foods. Access to food options (both transportation and retail
locations)
Barriers and obstacles to health equity range from limited language proficiency, lack of culturally
sensitive services, insecurity with the system, limited transportation, health illiteracy, and scarce
resources.
Leaders, including elected officials, businesses, healthcare providers, etc. who are committed to
improving health and quality of life in Cobb County.
Some groups just don’t know what is available to them. It’s an education issue.
Personal choices, poverty, access to primary care for uninsured (particularly pregnant women), old
habits, lack of health promoting policies and environmental changes
Funds as well as competing priorities for existing health providers and organizations / Lack of affordable
transportation, bus lines, or other public transport options
I don’t think there are any, other than people working together and dealing with traffic and growth.
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Not aware of resources available
Limited funding/resources
Transportation
Affordable and safe housing
Language barriers
Barriers include access to quality health care in the communities listed above. There are transportation
issues for patients seeking treatment in Cobb County. Many of those who need medical screenings
cannot afford to take time off work during the week to schedule those. They also may not have health
insurance and/or are undocumented residents.
Barriers such as transportation, language, child care, financial are a few of the barriers that exist which
keep the health and quality of life in Cobb County from improving for these populations.
Lack of education. Poverty.
Median income levels are too low to attract top-level physicians into this area.
Access to grocery stores and also to affordable and preventive health care options including mental
health care, grocery stores, lower income – moderate income communities
Limited transportation to health care and fitness options.
Lack of amenities like sidewalks, trails, bike paths, parks, playgrounds, fitness centers, gyms and other
amenities to address health and fitness in lower income areas
Regular daily exercise or recess in school settings.
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Continued efforts are needed to educate and change behaviors. In addition, transportation (public),
money/finances, language (Hispanic population) all impact those struggling with health and quality of
life issues.
Lifestyle choices are major contributing factors to poor health and quality of life. In some cases,
genetics play a role in increasing the predisposition to certain health related problems such as high
blood pressure and cholesterol problems. Lack of education attainment, healthy environments, food
choice limitations, transportation options, citizenship, and unhealthy sexual behaviors also contribute to
problems as well. Good prevention options, proper diets and exercise options are not available to all of
the citizens who are homeless, alcoholics, drug users and ex-offenders.
Stigma of addition. Not recognizing and treating addiction as a disease. Not supporting recovery.
Access via transportation is the biggest single barrier.
Access, access, access.
Need to get more fruits and veggies into food pantries and food deserts.
a) Rise of suburban poverty
b) Transportation to healthcare for those living in poverty – the biggest challenge we face in Cobb, and
frankly, Metro Atlanta.
c) Mental health – stigma
d) Gap in healthcare coverage – rising healthcare costs
e) Access (different than transportation)
High cost of medical care, even after insurance pays. Lack of clear government vision to help seniors.
these issues?
Cardiovascular disease, diabetes, mental health, access to services and housing for low-income >




More collaboration among healthcare providers, communities, public health, and communitybased organizations targeting health needs
Create and implement and get local government buy-in for a regional plan to improve public
transportation options and reduce traffic congestion for metro areas
Increase funding for mental health services
More options for low-income elderly housing
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
Create emergency shelter options for disabled and/or elderly
Alzheimer’s and other dementias / cancer > More facilities with affordable care
Obesity. Junk diets. No free clinics for blood pressure monitoring and diabetes education > have the
county declare walking the official exercise of the county > A neighborhood clinic – free clinics in more
communities and a year-round fresh food market.
Obesity, which contributes to heart disease, high blood pressure – diabetes, breast cancer, prostate
cancer > education, early screening.
Obesity – lifestyle induced disease. Lack of movement > Increased movement in schools and increased
activity with seniors. Work from bottom up – get the kids and you get the adults.
Obesity, because of its direct correlation to so many specific issues (hypertension, cancer, diabetes, etc.)
> Continued education, public outreach campaigns that encourage realistic exercise and healthier diets.
Obesity in an overwhelming portion of the population which is causing heart disease, diabetes and other
life threatening disease. Also, a dramatic rise in prescription pain medications that are causing addiction
which leads to potential illegal narcotics usage. Additionally, mental health issues are a major concern
in our community and there needs to be more avenues to treat people with these issues > Better
health/nutrition education starting in the elementary school and continuing throughout high school.
Public service ads with health related issues playing on TV and radio instead of fast food ads.
Diabetes. Heart disease. Obesity. > Wellness education: eat less/move more! Change work
environments.
Emergency room services and medical care of indigent and those without insurance coverage that don’t
necessarily require emergency room services but go there for medical attention. > Don’t know
Obesity and the resulting complications that occur as a result – hypertension, Type 2 diabetes, etc.
Growing use of opiates. > Consistent support of the message of choosing healthy lifestyles and making
smart choices. From schools to commissioners and libraries to churches.
Chronic disease management issues around the major causes of mortality and morbidity continue at
critical to be the major challenges of Public Health within these problems. The complex comorbid
conditions around obesity, cardiovascular disease, Type II Diabetes, and cancer are the leading critical
health problems. Risk factors management directed at smoking cessation, physical activity and
nutrition are established key determinants of health. Mental Health is a serious public health issue that
underlies all chronic disease management that is often overlooked. > The issues with health disparities
are complex and multidimensional. Understanding and creating policy to positively impact the
sociocultural determinants of chronic disease requires collaboration of multiple stake holders with the
common goal of improving the public health and reducing health disparities. At the moment the most
promising collaboration of that of the Chronic Disease Council under the Chronic Disease Prevention
81
Section of the Georgia Department of Public Health answering directly to the Commissioner of the
Georgia DPH.
Adequate healthcare options and accessibility for seniors and children from disparate families.
Diabetes, hypertension, cardiac issues, mental health, dementia and Alzheimer’s. > Serious
commitment among everyone/all stakeholders to address/fund treatment options.
People going to the ERs instead of the doctors’ offices > Better education, probably through schools.
Obesity – Cardiovascular disease, motor vehicle accidents for youth, mental health issues > Better
cross-county/city policies and environmental designs to support healthy choices, individuals taking more
responsibility for their own health choices (and for their children), affordable access to preventative
health activities / services.
Lack of access to specialists / Lack of access to primary care - Therefore poorly managed or untreated
chronic disease that turn into major health problems (heart attack, stroke etc.). These life altering event
make affect people’s permanent ability to work, ability to afford ongoing medical care, ability to afford
ongoing life expenses (housing, school, food etc.), and bigger burden on the hospital system and tax
payers. (An ICU hospital stay and heart attack is more expense than ongoing physician checks and
medication).
Lack of organizations working together for information sharing (records and technology sharing. This
includes best practices, medical information, financial information, lab share etc.) > I would like to see
the community work together by sharing their organization’s real priorities and needs with one another,
and then pulling their budgets together to really make a positive impact. There is lots of great
conversations and community pride in our county, many organizations work together well. But often,
after numerous meetings, the funding to accomplish something realistic gets dropped. We need more
primary care providers for safety net clinics. We need more community support (donations) to keep
these clinics going (and growing). We need everyone to do a little. We need specialist to do procedures
and psychiatrists to provide mental health oversight.
We need people to think creatively about what is the real, long-term cost and consequence by not
partnering together. We need leadership to not just think about this year’s bottom line, but five years,
10 years from now.
We need to go a step further and promote Wellness to the underserved not just chronic disease
management. We need to go above and beyond “patient education” flyers and 1 day health fairs where
you tell someone they have high blood pressure and bad vision, but no doc to send them to for
medication, and no option for purchasing glasses. Take some health fair money and provide
ophthalmology exams and pick-up glasses the following week. Do the same for hearing aids. Or put
those marketing funds for a safety night to hire an NP 1 night a week to do urgent care or Coumadin
checks. Whether this is through existing health fitness centers, schools sharing track fields and gyms,
etc. where more low income families can have safe way to exercise and prevent the development of
chronic disease.
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Care for children (early childhood care from birth and even before through 18). Care for the elderly. >
Access, required basic care prior to babies being released from hospital. Monitoring of care for the
elderly.
a.
b.
c.
d.
e.
f.
g.
>
h.
i.
j.
k.
Mental health issues such as depression, anxiety, stress
Obesity or overweight
Physical inactivity
Poor sleep habits
Diets low in fruits, vegetables, and whole grains
Sexual assault/interpersonal violence
Affordable mental health care; education to reduce stigma
Improve access to healthy foods; make convenient and affordable
Safe space for physical activity
Bystander training for interpersonal violence prevention
Access to screenings and medical care.
Poor nutrition habits and lack of physical activity.
Transportation to medical care, especially for the elderly and disparate populations.
>
Public funding for screening coverage and healthy food. Organizations have focused on working with
children, but also need to focus on parents and employers on the importance of nutrition and physical
activity. Work with community health workers to educate the high risk communities on the importance
of these issues.
In my opinion the most critical health problems are: STDs and lack of education on how to treat/screen.
Lack of health education, Alcohol abuse, Unsafe sex. > Education/navigation, resources to assist the not
served/underserved populations.
Diet, exercise. Preventive health ignorance. > Community Outreach and collaboration with community
outlets.
Obesity or obesity-related disease > education.
Overweight, obesity, mental health, diabetes, high blood pressure > Stress in lower and moderate
communities with minimal recreational opportunities, health options, food options, medical facilities,
and opportunities to congregate and fellowship with neighbors and friends exacerbate other social and
economic challenges related to limited transportation options, limited higher education and vocational
opportunities, employment opportunities, disparate crime and policing practices, etc. The issues are
multi-pronged. Access to health care options and balanced grocery options is definitely needed along
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with efforts to add additional transportation and recreational infrastructure and amenities. Efforts need
to be also included to address crime, employment, and education.
Weight: Being overweight often leads to high blood pressure & diabetes. Those health problems are
perpetuated by unhealthy choices: lack of exercise and diet. It is a cycle. Overtaking prescription
meds/drugs (specifically those taken in place of prescription meds): Impacts quality of life as this leads
to not only the obvious issues but again cycles into poor choices made in terms of food, exercise and an
impact on income or even job loss > Free events that promote healthy lifestyle and assistance to those
in need. Improvement in public transportation. Programs to educate young people and expose them
to healthier options.
The most serious problems are obesity, high blood pressure and high cholesterol leading to heart and
other health problems; drug usage; HIV and other sexual transmitted diseases, stress, violence,
children’s health problems associated with poor prenatal care, kidney failure and cancer. > Focus on
proper child care as relates to parenting. Focus on proper diets, breast feeding babies, healthy life
styles, importance of education with an emphasis on learning skills for career focus, communication,
critical thinking, saving money and not being a consumer only and thinking about future focus events of
life (deferred gratification) vs immediate gratification.
Disease of addiction > Support recovery
Obesity and mental health > Unrestricted access to education, access and access to care.
Dental care is huge as well as behavioral health > Access, access, access to low cost care.
Childhood obesity. Prescription drug abuse. Teen suicide. > Education our kids on long-term (what this
means for them). Provide healthy alternatives /ideas/recipes. Have more exercise in schools.
a)
b)
c)
>
a)
Chronic disease
Obesity – lack of proper nutrition
Affordable healthcare for those in poverty
Prevention is perhaps the hardest message to “sell.” We are traditionally a reactive medical care
society – we go to the doctor when we have an issue or are sick, not before there is an issue.
b) Food labeling could become more transparent
c) Access to affordable healthcare for the dramatic increase in those living at/below poverty in Cobb.
Medical care is expensive and complicated/demanding timewise (to navigate) > Evaluate single provider
solutions
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community:
Alcohol abuse
111111111
Illegal drug abuse
1111111111
111111111111
Unsafe sex
111111
Lack of exercise
1111111111111111111111111
1111
1111
111111111111111111
1111
Not washing hands
Poor eating habits
11111111111111111111111
Drunk driving
1
111111111111111
Suicide
11
Violent behavior
1111
OTHER: Lack of healthcare and prevention of child abuse for children / underemployment and unemployment
and poor transportation access / stress / over prescribing of opioid medication. Being too ashamed and
ridiculed to see a doctor. / Undiagnosed mental health / Unsafe driving / Lack of complete personal health plan
Elder abuse registry (?), Medicaid expansion, smoking bans, funding for more transportation option
(such as FLEX), improvement in sidewalks and more pedestrian-friendly areas, funding for lowincome/mixed use housing, create an emergency shelter program for older adults.
Inpatient services for elderly with little income. Coordination of services among agencies.
Medicaid expansion.
In school movement
Prescription drug abuse education for medical doctors as well as the public.
Any program that could successfully find ways to encourage healthier lifestyles and provide education
toward access to healthcare.
I would suggest allocation of our tax dollars to be spent on the education of our children throughout K12 on proper nutrition and exercise. Additional spending on the dangers of prescription drug abuse.
85
Allowing people to use benefits at fresh markets and doubling amount of spending power for fruits and
vegetables. Free dental exams for children.
Medicaid Expansion for the State of Georgia. Immigration Reform.
Getting fresh food to areas. Educating about immunizations. Having some sort of counseling in the ERs
to get folks to go to doctor instead of ER.
Tobacco free policy across all cities and county to include bars. Healthier designs in streets/sidewalks to
promote more walking.
Here is my long list. I would support: sharing spaces, schools opening up gyms and fields, more federal
and state allocation for primary care, safety nets, tax incentives for hospitals to provide charitable and
DSH care, sovereign immunity and tax benefits for specialists (or any provider) who saw charitable
patients (under 200% of poverty) for free (even if it was in their own office and not at an FQHC), more
tax benefits for outpatient (AND Inpatient) surgery centers to provide charitable care, additional funds
or appropriations for FQHCS, hygienist who could see patients in the office even when a dentist wasn’t
present (like many other states), hygienist who could administer anesthesia, Increase taxes for more
public transportation, insurance and claims reform for mental health access, explanation of 340B
discount (drug access) program, sharing of information and technology among health partners for
better collaboration
Mandatory testing for health risks prior to babies being released from hospitals after birth, accidents,
etc.
l.
Increase safe places for physical activity; sidewalks and bike lanes separate from
highway/roads/streets
m. Healthy eating programs-fruit and vegetable mobile markets
n. Mental health screenings (take to communities)
I would support increase in tobacco tax, as Georgia has one of the lowest in the country. The funds could
be used for healthy lifestyle programming in high risk communities. I would advocate for nutrition and
physical activity policies at state and local level. I would also support the work of the Breast and Cervical
Care Program (Partnership with DPH and ACS) by promoting the screening and education events held
throughout the county.
Education and community outreach.
Programs which make use of “wasted” or leftover food items by getting them to those who are going
without:
-leftover food from restaurants, markets and schools “donated” to organizations for
distribution.
-backpacks home with food sent home with students for weekends/holiday periods
-food giveaway – advertise/promote where to go to get and how/where to take donations
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-feeding stations on holidays within the county (volunteer opportunities – lacking options or
communication to notify of the needs/options)
-Government reform to allow leftover food in schools to be redistributed.
Programs to increase the opportunity for students to move (i.e. recess, standing desks, extracurricular
activities associated with exercise programs)
Policies to insure adequate healthy medical care for children and families; resources for adequate
healthy food for children and families; proper housing; birth control; mental health treatment resources;
drug treatment programs and violence/bully prevention programs.
Supporting recovery. Educating the public regarding the dangers of prescription medication (including
the medical community).
Funding for school-based health centers and mental health care.
Access to low cost healthcare including primary care, specialty, dental, and behavioral health, free
immunizations, access to low cost medications.
a) Collaborative/community approach by leaders in non-profit and healthcare community to develop a
“healthy cobb” prevention message
b) Any priorities which have stated outcomes and increase access
c) Healthy eating and exercise initiatives – that are not the “same old tired” approaches - unique, eyecatching, and participatory.
Better managed healthcare organizations. Single payer health plans like Kaiser. Integrated health and
wellness programs such as Cobb Senior Services. Competition among healthcare providers.
Creating lifelong communities (http://www.atlantaregional.com/aging-resources/lifelong-communities)
More facilities in county – more access. Software programs to share data among some providers.
Partnering with churches and other community organizations to educate and assist with healthcare
initiatives and preventative care.
Less traffic on our roadways, more access to affordable health care and placing incentives on insurance
premiums for healthy living.
Improve transportation. Improve Obamacare – it’s not working. Give incentives to businesses that
promote wellness.
87
Offering educational programs to the general population on drug abuse and smoking as examples. Also
to continue offering free health screenings and health fairs.
Sidewalks and lighting in underserved communities.
More economic opportunity, more commitment of major stake holders to invest in community
development, green spaces, public health FQHCs, education both for children and parents.
Better access to primary care for uninsured individuals.
For people of influence and affluence to hear the cry of those in need and respond. For businesses and
organizations alike to commit to serve the underserved, giving the voiceless a voice and championing
their needs to make a better community
Commitment to children and their well-being rather than stopping behaviors.
Not sure.
Additional education and outreach from the health care systems to targeted communities. Including
partnership with health organizations to promote and support these events.
Use of internet and social media to promote healthcare to citizens.
Better education.
Community engagement as people who that they have the ability to impact their outcomes can reduce
stress levels.
Volunteer programs – communication as to when /where. People are looking for service opportunities –
schools/youth groups.
Violence prevention in our communities is so important. Young and old alike are stressed out because
of it.
Community support to change the stigma of addiction.
Expanded dialogue with community-based providers.
Education, outreach and access to care.
Mandatory health classes and programs related to receiving benefits, safe driving courses, dental care
and vision care must be wrapped into healthcare.
7.
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CCT FLEX (I think it will improve health moving forward)
http://www.cobbcounty.org/index.php?option=com_content&view=article&id=3600&Itemid=1647
Community change: Opening Senior Wellness Center
YMCA’s Fresh Food market pilot program of 2014. Unfortunately, in 2015, it did not return to a location
closer to the people that needed the items.
Healthcare or community sponsored walks/runs that raise awareness to difference health issues and
priorities. These events are effective because it gives participants a bag of information on healthcare,
support organizations, and usually activities for the entire family. It also gives participants an
opportunity to exercise with promotes lifestyle changes.
Cobb2020
Fit City Kennesaw (fitcitykennesaw.com)
It’s not here in Smyrna yet (WHP), but soon will be. I believe the “health park” healthcare delivery
model represents modern-day needs.
Alive Ministries which just announced a merger with MUST Ministries – Alive has placed food pantries in
20+ schools in Cobb for families who are food insecure. Children who are hungry cannot learn and
thrive. As we try to end the cycle of poverty, hunger and sickness, this service has been a tremendous
asset to hundreds of families.
“Nuestros Niños” Pediatric Clinic run by dedicated compassionate nurse practitioners who treat many
of the areas children and adolescents without regard to the families’ insurance status, language or
cultural obstacles or undesirability as patients. They are a selfless group struggling in private practice to
deliver high quality pediatric services to the most vulnerable populations in the area. They are a prime
example in the Metropolitan Atlanta area of small privately owned clinics that are not asked to be on
steering committees, councils or task forces and are often forgotten. They are the real stakeholders
along with their patients who continue to care for the most vulnerable populations.
Giving people access to fresh vegetables. Good Samaritan has provided more health services in Cobb.
Farm Fresh Farmer’s Markets
There are several projects that I could name here but a few that really stand out: Cobb Services Board
and Good Sam working together to get primary care access to their dual diagnosis (substance abuse and
mental health disorder) patients a more integrated and interdisciplinary treatment plan for care.
Ser Familia’s ability to hire a Spanish speaking counselor to serve the Hispanic population.
Cobb2020/Healthy Lifestyles Farm Fresh initiative to get culturally appropriate, affordable, healthy
foods to some of the food deserts, to the underserved.
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Children’s Advocacy Centers. They include healthcare, screening and risks assessments.
Culinary Sustainability within Culinary Services at Kennesaw State University
http://dining.kennesawstateauxiliary.com/sustainability/culinary/
Focus on farm to table, energy savings, and lower food waste. The initiative involved all levels of our
campus community. Great promotion was conducted on what they were doing and the quality of the
food ingredients. All of this was launched with the new dining facility, The Commons, which opened
approximately 5-6 years ago.
Our American Cancer Society Client Navigators work with the Georgia Breast and Cervical Cancer
Program and are based on local health departments or BCCP providers to assist low-income women 2164 to get breast and cervical cancer screening at low or no cost to them. They also assist the BCCP
women over 50 years of age in getting the colorectal cancer screening. Funding for the program comes
from United Way, state of GA and ACS. We are always looking for additional funders for the program
across GA. For the period of time between July 1, 2014 and June 30, 2015, the Client Navigation team
educated 12,357 women about breast, cervical & colorectal cancer education and assisted 1,813 in
getting their mammograms – 44 percent of the women who received mammograms are considered
never or rarely screened for breast cancer.
The BreasTest Program here in GA, specifically Cobb County has helped 1300 women get screened for
Breast Cancer. The program was successful because Client Navigators assisted and educated these
women to get services needed.
Health fairs wherein people get free health screenings and advice. There was also a community health
clinic in Mableton that seemed to make an impact until it abruptly stopped.
Unknown.
More recreational opportunities.
Walk GA – Cobb2020: Our system competed in several sessions while there was some level of
competitiveness overall the encouragement among participants went a long way toward the overall
involvement.
Alive Ministries is a program designed to provide food to families over the weekend so that the students
will have food to eat. Recently, they became a part of the wonderful MUST Ministries Program.
However, so many young folks are not getting adequate food or nutrition so they are subjected to
immune system challenges.
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Prescription “Take Back” programs. It worked because so many people were unaware of the dangers of
left-over medication. It worked because so many people were dying due to “the family medicine
cabinet.”
The State’s CORE services program. This program allowed for numerous consumers to qualify for
health/mental health care insurance coverage and is community-based in its approach. Funding for
“home based” care is huge in removing the access issue.
Community clinics that have been opened in high-risk areas. They provide access to some healthcare.
a) The fight to eradicate childhood hunger and incorporate some “healthier” eating initiatives.
b) Community clinics and mobile healthcare – access improved for those in poverty who have limited
transportation options.
Cobb Senior Services is moving toward responsibility for health and wellness, to include WellStar.
Working together is the differentiator.
or highlighting.
Friends and family
11111111111111
111111111111111
Internet
111111111111111111111
111111
Television
11111111
Hospital
111
9.
Books/magazines
111
Free Care Clinic
111
Social media
111111
School
11111
Congregation
Newspaper
Other:______health fairs / community outreach &
health fairs, cancer talks in churches / Blue Cross Blue
Shield
Animal control
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1
111111111111111111
11111111111111111
Bioterrorism
1111111
Homelessness
111
111111
1111111111111111
11
Lack of health providers 111111
What kind? Dental and mental / primary care / mental
health / specialists – endocrinologists, orthopedist, GI,
and GYN / addiction / primary care, dental, specialty,
behavioral health
111111111111
1 – add lack of community amenities
111
1
Domestic violence
1
Youth crime
11
1
Literacy
1111
Secondhand smoke
1
Work safety
111
111
Neglect and abuse 11
Elder ___ Child ___
1
111111111
Racism
11
11111111111
Unemployment
11 - add underemployment + low higher education or
vocational training opportunities
Violent crime
Gang issues
1
Others: ________________________
No support for recovery in long-term re-entry.
Support for family caregivers
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Just want to emphasize that there is a gap in Cobb County driven by zip codes – where you live can
largely determine the quality of your health.
There are many NGOs involved in solving these issues that need to be brought to the table. Too many
discussions are dominated by the large corporate health systems that by definition are removed from
the community.
This survey does not seem to specifically address the large and growing Hispanic population in our
community. Access to culturally and linguistically appropriate services is a growing need. Interpreters
are needed in every healthcare facility, including mental health.
No.
Not that I can think of at this time.
Not that I can think of.
Low income and lack of education are the key elements.
Not that I can think of at this time.
Schools are the support system for many young people today. The education programs are not
challenging the students like they should. Students are dropping out because they are disengaged.
WellStar could assist in getting their clients well both: physically and emotionally.
Yes – the availability for detox and substance abuse rehabilitation for those without money or insurance
is almost non-existent. We need funded organizations to help those in recovery stay in recovery. The
heroin relapse rate is 87 percent.
No.
It has not gone unnoticed the efforts that WellStar labels “Community Benefit.” It has been called
“marketing” by our competitors and we are eroding the respect of our community partners. As we
become an even bigger presence in OUR COMMUNITY, we need to be a better partner. We need to not
only help those who have the means, but those who do not and make an effort to make our entire
community a healthier one.
Collaborate with community partners to implement evidence-based interventions in the community
(not just individual behavior change, but high level interventions such as coalition building to support
policy initiatives, lifelong communities, transportation options, etc.)
Create grant funds for local community-based programs to implement above
Share healthcare data to help communities/community partner’s plan strategically
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Develop/incorporate/create a center to support integrative and/or alternative medicine approaches
(meditation, mindfulness, nutrition, acupuncture, etc.)
Develop a transportation program
Create an emergency shelter
More skilled nursing facilities at affordable costs.
Sponsor a focus group or panel discussion.
Health fairs.
Increase efforts toward “public outreach.” Find new ways to engage and encourage citizens toward
healthier lifestyles (partner with more 5k races within the community, have an even larger presence at
pre-planned events within the county and use these examples as a platform to spread the word about
WellStar services.)
Possibly hold more community health education screening opportunities throughout the county. They
need to be held in areas such as schools and community meeting venues.
WellStar built a large healthcare facility in East Cobb over the objections of many. Can you provide
transportation or access to those who don’t live close to that facility? I am sure that it would not be
economically feasible for WellStar to build a similar facility in South or West Cobb.
Make a statement of commitment to address the vulnerable populations in the community by investing
in the community making health disparities a strategic priority.
Invest more in obesity reduction efforts in the community.
Better communication to local partners. As a partner of WellStar's serving the vulnerable, I know there
are many more free or discounted education programs that they provide that we don’t know about. If
my staff is not aware, then we cannot help educate those we serve every day.
Consider putting staff at location where the most vulnerable are already going (existing safety net
providers). Think about sharing specialists now and as you are developing your Residency programs.
Open up specialty care for those patients desperate for life altering procedures. Put a cap on how many
people it is each month so you know what to expect. Let everyone give a little so the burden is light
-Allow WellStar’s malpractice to cover providers who do this - take away the providers’ barriers.
-Give other WellStar physicians the decision to see patients and waive THEIR fees if they want. The
hospital and facility fees can still go through the normal CFA process.
Tell the (community) story better.
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By becoming the experts in the field of child maltreatment in Cobb so that our resources are staying in
Cobb and not having to go to Metro Atlanta. Children are a major concern.
Provide grant funding for schools, businesses, universities, churches, etc. to address health needs in
their community. It would be a great partnership between WellStar and the community.
WellStar Health System could improve by focusing in on the vulnerable populations for these programs,
and promoting them to their partner community organizations.
WellStar can make it easier to help navigate not served or underserved populations. Double down on
community presence via health fairs, education to navigate these populations through their health
system.
Go where they go. Find out where they congregate and advertise there.
Continued spending of resources to keep facilities up-to-date.
Provide smaller clinics inclusive of urgent care facilities in more underserved areas.
Visit schools – educate students to make better choices; start young but also share options with older
HS level. Educational programs in low-economic areas – at community events (sports and cultural
events) for all family members. Volunteers – advertise and recruit – there are people looking for
opportunities.
Work with homeless shelters: Have special projects for the families and children which can teach them
to live healthy given their current predisposition. Create APPS for those involved in domestic violence
situations to help them help themselves and families; Support youth oriented programs at the YWCA,
Big Brothers Big Sisters and other programs (afterschool) to educate children about what are good life
style choices. Work with developing these kids’ minds by creating APPS for young folks with incentives
for living.
Begin to focus on recovery. 25 million Americans are in recovery. Let’s work to keep them there. There
is a national movement to support recovery and it has become a huge political platform. I would like to
see WellStar and Cobb County continue their cutting edge advocacy by embracing recovery.
Recent expansion via Tenet expansion is a great improvement as it gives a much broader “footprint”
through which to reach communities and consumers.
WellStar has an obligation to help not only the insured, but the under and uninsured of their
community. They are the biggest, and often the only player in time. With that power, comes duty.
Efforts to provide care, outreach and education need not be big ticket items-compared to the $575
95
million spent on acquiring new hospitals. Efforts need to be strategic to help the system and the
community simultaneously.
I believe it’s a collaboration of organizations that can make great impact.
WellStar does a great job overall – really noticed an uptick in a “customer service” approach over the
last two to three years – for the insured. Solutions to explore: a) expand collaborative partnerships
with other substantive non-profits engaging with, but not directly related too, healthcare – like social
service organizations; b) community and/or mobile clinics – let’s do mobile healthcare intervention and
case management!; c) partner with business community, non-profits, and government for a one-of-akind, unique, and totally COBB “healthy living” comprehensive and innovative, “replicable” approach.
Community Services Board, YWCA, MUST Ministries
WellStar – access, improvement of services (ongoing), staff
ACT Partnership – health fairs
Wal-Mart / Walgreen pharmacies and clinics – they are in their communities, reasonably prices and
accessible.
CHOA’s Strong for Life. Alliance for a Healthier Generation. Health Empowers. Lt. Governor’s Office.
Kennestone Hospital treats anyone who comes to the ER with outstanding service regardless of their
ability to pay or not. They are effective due to excellent doctors and nurses who care about the
patients.
Public health departments.
CDPH – multiple locations, free/reduced services and comprehensive services
The FQHC and collaborations such as Good Sam and Cobb 20/20. State-level initiatives. They are all
inclusive, engaging and level playing fields for frank discussion on societal issues.
Good Sam. They take care of the uninsured and underserved population.
WellStar – broad health system, community-based, many levels of expertise and resources
Public Health – population-based, public not private, mission to care for low-income, uninsured
Kaiser – prevention focused, experienced with cost control AND quality of care
Good Sam – Christian-based FQHC, mission, passion, federal funding
96
Good Samaritan Health Center of Cobb-we try to focus on what we do well
Cobb Services Board – although I know they need more funds, their approach to integrated care
(primary care and behavioral health) and peer-to-peer program is great
Northside- their version of CFA is very easy for community partners and patients to navigate.
Kaiser- Mixed support of giving out cash grants, seeing patients in-house, specialty care, loaning out
providers, joining community partnerships. They seem to have the mix figured out and they tell their
story well.
WellStar does a lot of great things-their partnership for Good Sam patients, by providing labs, radiology,
and cardiac studies is great. I have found that most people do not know this (except when we share the
story and try to publically thank them).
The time is now and WellStar has to become the experts in pediatric care and prevention of child
maltreatment and healthy child development!
I’m not sure that I can say one organization stands out over the other. That said, in regards to
intentional outreach to vulnerable populations, it seems to be the GA BCCP program as it is housed in
the health department and has a patient (client) navigation pathway started from screening to
diagnosis. It also collaborates with partner entities outside of itself to help fulfill this process.
Good Samaritan Clinic, in my opinion, is a small clinic in Cobb County that has been successful in taking
care of the needs of the underserved populations.
Cobb WellStar ER turns none away. They are the community health provider.
Urgent care facilities are helping to close gaps in access since they tend to be more affordable and more
responsive than ER.
Beyond the health department – as I am not a part of the population in need – I am unaware of the best
option(s).
Many organizations are working with these populations. County health services, MUST Ministries, and
some churches are working with the intent of helping. However, there needs to be a systemic approach
to care that is protracted care. Meals help, but the proper life style for feeling hope, peace, safety and
love is also required to thrive. Kindness is so important! Feeling CARED ABOUT is so critical to
sustainability. Other comments:
Veterans are experiencing some of the same problems discussed above—alcoholism, drug usage,
suicide, depression and other systems of trauma that are too detailed to discuss here at length.
Discrimination and racism either perceived or real is very threatening to one’s health and wellbeing.
Care for the aged is becoming more challenging as this population swells in the county. Services for this
vulnerable group will be required as more folks are moving into the 55+ age category.
97
Proper use of leisure is an important concept that many are not taught. Work is first required, then
play. However, when many have been unemployed or underemployed for a long stretch—the concept
loses meaning.
Long term care is a major problem for many. Data suggest that the elderly are not prepared for care in
the event of major illnesses. Prevention and planning are needed. Alternative methods of
communicating need to be utilized. Everyone does not have wireless or computer capabilities.
Non-profits! They are offering free services and oftentimes free medication or counseling. They are
helping those who can’t afford to help themselves.
Good Samaritan Center (off Austell Road) is a great clinic immersed in an underserved community.
There are several, both the Northeast Georgia and Kaiser systems make significant commitments to help
those in their community be healthier and more productive. Politics and profit are left at the door and
the community is becoming healthier through their direct assistance.
DOUGLAS
poverty.
Lower income and homeless are always an area of concern.
Low-income, minimum wage employees, single parents
Unemployed or underemployed. 30134.
Lower socioeconomic residents.
There are pockets of poverty in the 30134, 30122 and some 30135 addresses. The primary issue with
regard to health/quality of life is may low to no income citizens are still not insured and there are not
enough health care providers in the local area who are accepting new low income clients. Our chronic
disease numbers especially for African American males in the 30134 zip code remain exceptionally high
for such a small population of citizens. Due to cuts in funding for Youth Pregnancy Prevention, the
number of teens who became pregnant increased which had not occurred in previous years.
98
Transportation to and from services. Awareness of services. Self-awareness and concern is not present.
Transportation. Access to primary/specialty medical care.
Lack of care or failure to make good health a priority.
County-wide, coordinated effort.
Community apathy is a barrier. Most folk are not overly concerned that chronic diseases are negatively
impacting much of our African American male population. There is not much discontent among the
average citizenry about our lack of walking paths, bike paths, fresh food vendors, and other free to the
public healthy lifestyle choices. Community acceptance of the use of alcohol and other drugs by youth is
a barrier to prevention efforts. The number one suppliers of alcohol to youth in Douglas County are
family and friends of the youth abusing the illegal substances.
these issues?
Obesity, diabetes, communicable diseases, drug abuse
COPD, hypertension, diabetes and obesity > Education of the risks and better treatment options
Cost > Lower health cost
Obesity. Drug abuse. > More work by more people than just smaller segments.
Chronic Diseases, healthy lifestyle apathy, the proliferation of molly, heroine, and marijuana abuse
among youth. > We need more sidewalks to encourage walking in Douglas County. We need more
primary care physicians who are willing to accept new patients. We need WellStar Douglas to require
their doctors to volunteer at The CarePlace as those in Kennestone are required to do in their local free
clinics in Cobb County. We need parents to be educated about how entry drugs impact how youth view
drugs use and abuse as adults.
community:
Alcohol abuse
1
11
99
Illegal drug abuse
1111
111
Unsafe sex
1
Lack of exercise
111111
1
1
Not washing hands
Poor eating habits
11111
Drunk driving
1
111
Suicide
Violent behavior
11
OTHER:______________________________________________________________________________
More focus and services toward health living programs for children and adults. Partnerships that work
with county schools and businesses to reduce drug abuse, poor eating and lack of exercise and in
increase in drug rehab programs.
Funding for free clinics.
Cheaper medical care and services.
School-based health centers.
I would support subsidies or tax breaks to doctors to volunteer at the Care Place or treat indigent
clients. I would support increase the tax on alcohol and tobacco to raise funds for ATOD prevention
initiatives. I would support, a one cent SPLOST to increase the capacity of our hospital to serve clients
with strokes. I would support a one cent SPLOST to add sidewalk paths from every neighborhood to
every school to encourage youth to walk to school.
No opinion.
More family doctors.
Awareness campaign.
100
There is much prevention education needed.
7.
The CarePlace reduced ER visits by our patients by 52% from prior to their first visit to the CarePlace and
thus receiving ongoing primary care.
Youth getting required shots.
Health and exercise programs within the school system.
Douglas Alcohol Prevention Program and CORE sponsor Power in Truth every year in October. The fact
that they have educated on average 400+ students on ATOD use prevention for over 10 years in a row
has been significant in offering both the right amount of information in a consistently yearly dosage to
truly impact how our youth view ATOD abuse. The commitment of the community from the Douglas
County School System to Cobb/Douglas Public Health, Douglas County Board of Commissioners, City of
Douglasville, CORE, United Way, to the Chamber to support Power in Truth for over 10 years is the
difference and has sustained this program.
or highlighting.
Friends and family
111
11
Internet
1111
11
Television
111
Hospital
1
Books/magazines
Free Care Clinic
1
Social media
111
School
11
Congregation
Newspaper
Other:__________________________
101
9.
Animal control
1 (including insurance affordability), 11
Bioterrorism
11
Homelessness
1
1
11
What kind? Primary care / Primary care
1
1
11
Domestic violence
1
Youth crime
1
Literacy
1
Secondhand smoke
Work safety
111
11
Neglect and abuse
Elder ___ Child ___
1
1
11
Unemployment
11
Violent crime
Gang issues
Others: ________________________
No.
1. Partnership with school and small businesses.
2. Producing fun and engaging family activities that promote exercise and healthy living
102
Have clinics in areas around the county.
Must seek out and identify then attempt to provide services.
1. Offer additional classes to the public and advertise them in places that most folk visit.
2. Continue to expand to offer more services locally (stroke care would be great)
3. Continue to collaborate with Douglas CORE to inform the social and human service community about
all the wonderful work occurring at WellStar.
4. Continue to fund Safe Kids initiatives.
WellStar and several of the local drug stores.
Medical providers – resources. Schools – burden often placed on this entity because of perception we
have contact with many.
The Care Place with the assistance of WellStar is best helping with indigent care needs. WellStar is our
only local hospital and provides the most indigent care services. Thank you!!! Cobb/Douglas Public
Health are doing great public education initiatives and prevention work in the areas of injury prevention
(Safe Kids), ATOD prevention (DAPP), chronic disease abatement (Live Healthy Douglas).
PAULDING
poverty.
Don’t know any geographical pockets of poverty. There are many low wage earners / families countywide that are challenged to meet living expenses and pay for healthcare.
People who have been released from prison, mentally ill, those on drugs, the very low-income, homeless
and those who are disabled but not yet receiving benefits. (Those needing education on their disease
at no cost – from where I set it all boils down to people having enough money to be able to pay for the
services. When there is no money they do without and in some cases they make choices between
paying for housing, utilities, food, etc.)
103
Underinsured and under-employed. Children of underinsured and under-employed. Those needing
medical services.
Areas near downtown Dallas as well as areas in Hiram have pockets of poverty evidenced by
government housing, run down mobile home parks, and dilapidated houses. These individuals may lack
access to preventive healthcare due to financial barriers, lack of insurance, or lack of adequate insurance
coverage.
Uninsured and underinsured throughout the county. Even those who have some form of health
insurance through the Patient Protection and Affordable Care Act. This is because of the high
deductibles associated with those low monthly payments. These deductibles are too high for low
income people to be able to pay. Furthermore, recent studies have indicated that some of those who
had signed up for the ACA are no longer enrolled.
People that are at risk are those who live at a lower socio-economic status. These people are either
under cared for or don’t have the knowledge of how to care for themselves.
Latinos are getting poorer.
People without transportation, health insurance, people with a lower socio-economic status, students
who lack positive role models, substance abusers, increased heroin usage
Homeless and seniors
Failure of Georgia to expand Medicaid is a barrier to improving health.
Federal government.
Lack of funds to pay for the services of a professional, doctor and/or dentist. Lack of funds to actually
get the RX that they need. Even our senior citizens (on fixed income) sometimes choose between their
prescriptions, food and paying their utility bill/rent.
Lack of primary care providers, lack of mental health professionals.
Many adults living in Paulding travel outside the county for work spending close to two hours each day
in their vehicles. This essentially adds two hours to the workday which is time that could be spent
outside with their children or engaging in other activities such as exercise programs or community
activities.
The only barrier will be the inability of those in a position to help (volunteering / donating funds, etc.)
who do not make the effort.
104
I think the most important thing that would help the quality of care in our county would be if there was
a place they could go that could provide adequate healthcare at a free or reduced cost.
Access to services, transportation issues
Lack of pediatricians accepting new Medicaid patients. Lack of resources for special needs children (i.e.
sign language classes). Lack of family support resources. Financial resources. Lack of resources for
adult male services (i.e. colonoscopy, prostate exams, etc.)
I think our citizens need to be educated about what is available to them and for WellStar to push more
screening.
these issues?
Obesity, diabetes, smoking.
Cancer, diabetes, obesity, prescription drug abuse
Those that are on maintenance medicines for diabetes, high blood pressure, heart and lung issues, and
no access to having their labs done. Some of the medicines they can get for free from Publix but they
still need a prescription. > Have a clinic that they can not only see a doctor but one that has a
prescription program where they can get their RX at free or reduced cost.
Lack of mental health services > More services and better access
Obesity, Diabetes, COPD, Depression and Heart Disease > Prevention. All of these diseases are (for the
most part) preventable. More needs to be done to address behaviors. I personally know that my child
can purchase a school lunch and bags of chips and cookies and brownies in addition to that lunch. I am
very uncertain as to why this is allowed. At our ballparks where our children play sports, smoking
should not be allowed. More community groups focused on health and wellness, fun-runs, community
workout days in the park….these things would all draw individuals out of their homes and get them
active.
An overall whole approach to healthcare needs to be considered. The Paulding Community Health &
Resource Center has as its mission and vision statements the following: Mission - The Paulding
Community Health & Resource Center will serve as a compassionate community wellness resource for
those who are underserved and most vulnerable. The Center will also serve as a safety net solution by
providing resources and referrals to community and government services while promoting life skills
development and life-long wellness at a centralized location. Vision - The Paulding Community Health
& Resource Center is envisioned as a comprehensive and sustainable community center with the goal of
providing long-term health and wellness services leading to healthier lives, healthier families and thus, a
healthier community. Strengthening Individuals – Healthier Families – Community Health
105

A community healthcare and one-stop services center with the widespread support of the Paulding
community
One of the main problems I see in my line of work is the excessive amount of people having children
that cannot properly take care of them. Many of these people cannot take care of themselves, much
less a child. > People need to be educated and show that it is possible to not have a child every time
you have sex.
Diabetes, breast cancer, mental health, high blood pressure, autism > comprehensive approach to
education and screening.
Hypertension, diabetes, obesity, mental health. Lack of knowledge concerning school immunization
requirements (adults as well). Nutritional education lacking. > Access to resources for uninsured,
underinsured. Increasing number of providers in the area. Recess/ health education (activity in school)
Partner with Georgia Shape program - www.georgiashape.org
Drug and alcohol addictions > I am not sure.
community:
Alcohol abuse
11111
Illegal drug abuse
111111
11
Unsafe sex
111
Lack of exercise
1111111
11
11
1111111
11
Not washing hands
Poor eating habits
11111111
Drunk driving
11
111
Suicide
1 (mental health)
Violent behavior
11111
OTHER:______________________________________________________________________________
106
Schools need to encourage exercise and good nutrition. More help needs to be available for foodchallenged families. More assistance needs to be given to uninsured or underinsured when dealing with
chronic illness.
We are a non-profit organization feeding the hungry. It takes a lot to keep the doors open.
Primary care and mental/behavioral health service funding
Funding priorities: Public tracks with playgrounds, recreation centers for children after school, smoking
cessation programs, mental health screenings and referrals
I would support an extensive support and funding program by the WellStar Health System.
We need to help those who are alcohol or drug abusers. In my opinion, those are the two most critical
problems.
Ensuring families know where to go for services that are not the ER and improving access.
Proactive prevention / education.
Public transportation.
STI / Family planning education - schools
Georgia Shape program/initiative – prevention of childhood obesity
More Federal assistance
A birthing center.
More industry and jobs – On Job Training – companies willing to educate and train under-educated
people who are willing to work.
Coordination of agency efforts and resource management.
Jobs in Paulding County.
Widespread cooperation form government health agencies, non-governmental healthcare organizations
and faith-based organizations in the county including the connectivity among these agencies with the
Paulding Community Health & Resource Center will work in implementing.
107
I think if there was a way to educate young people about the dangers of drugs/alcohol and the impact
that unsafe sex has on society, it would be helpful. But this would have to be done in a way to really get
their attention. You could not teach it in a traditional manner.
Mental health – many physical problems are the result of depression.
More jobs would keep more of our citizens from traveling out of Paulding and lower stress for them.
7.
Encouraging additional specialists to operate clinics in Paulding County has improved overall access.
There are twice as many specialists with offices in Paulding as there were three years ago. The new
hospital has doubled the inpatient capacity over the old location – with another doubling to occur over
the next two years. Inpatient census has been running near capacity. More people are being treated
locally and not being transferred.
New WellStar Paulding Hospital.
Community Supplemental Food Program for Senior Citizens 60 plus years of age. Those on fixed income.
We (Helping Hands) have been able to collaborate with the ACFB to bring this program to our county.
This helps to get our seniors the good food they need for their bodies.
The new Paulding Hospital and outpatient facilities. The location is very accessible and easy to find. The
facility is beautiful and welcoming and the design included elements that make the building more cost
efficient to run. The additional outpatient buildings have added specialty care access and the system is
currently working on a plan to house more primary care.
There are many but the one that specifically stands out is the Paulding Family Connection Children’s
Cabinet (www.paulding.gafcp.org). This organization is improving the condition of children and families
with the metrics to prove their effectiveness.
I think the Paulding Meth Alliance / Family Alliance of Paulding have made some great strides in helping
the overall health of our county. They have helped educate drug abusers and turned many of them
around in life. It does not work on every person, but it is better than doing nothing at all.
Ser Familia - schools and parent liaisons – churches (80 percent of their referrals come from schools and
churches)
In the works – Paulding Community Health & Resource Center. Current program / community change –
Creating Communities of Hope – Paulding is part of The Northwest Georgia Region of Hope – partnering
with our community, Judge Miller, Casey Family Program.
108
Not sure about that.
or highlighting.
Friends and family
1111
111111(for Latinos – doctors not associated with the
health system)
Internet
1111111
Television
1
Hospital
11
1
9.
Books/magazines
Free Care Clinic
1
Social media
1111
School
Congregation
1
Newspaper
Other:__________________________
Animal control
1111
1111
Bioterrorism
111
Homelessness
11
111
111111
1
Literacy
11
Secondhand smoke
1
Work safety
1
11
Neglect and abuse 1
Elder ___ Child ___
1111111
Racism
1 (Latinos have no sense of belonging – self-worth
issues)
109
Lack of health providers 111
What kind? Primary care and mental health / primary
care/pediatrics and behavioral health / mental health
11111
1
1
Domestic violence
111111
Youth crime
1
1111
Unemployment
111
Violent crime
Gang issues
Others: ________________________
Transitional housing and homeless shelters.
No – it is well done!
No – comprehensive in scope.
No.
Expand clinics for needy.
Set up health fairs in their neighborhoods.
Spearhead a clinic (medical and dental) for those who are financially strapped.
Support the Paulding Health and Resource Center!
Increase primary care, pediatric and behavioral health access
Educational sessions at the boys and girls club and any of the other recreational facilities in the county
Community “Get Moving” days on the grounds at the courthouse.
By implementing its CHNA recommendations with the Paulding Community Health & Resource Center,
WellStar Health System can make a marked difference in the healthcare of, and outreach to, the
residents in the county.
WellStar could actually go out in the community with teams of people to help educate citizens on what
is going on at the hospital and what they offer. This would need to be done in mobile home
communities as well as downtown housing projects.
Partnering with Paulding Community Health & Resource Center, Public Health, etc. – community
partnerships. Mobile units for mammograms, dental, etc.
110
Send trained personnel into the community to reach those in need of our services.
The county health department (although I believe the private sector would do a better job. Funded by
government). Local hospitals as they are required to assist even those who cannot pay. (I am aware
WellStar has budgeted for this area) Not positive about others.
Rapha Clinic in Temple, GA (Carroll County) – the clinic has volunteer professional medical personnel
and labs who donate their time to help those in critical need who cannot afford to pay the high doctor’s
visit.
I’m not sure. I know that WellStar is committed to our communities and is working on a plan in each
hospital service area to support our vulnerable populations. We will have one in Paulding County I am
sure!
WellStar Health System
Family Alliance of Paulding
It is not apparent in my opinion.
Paulding County does not have a community health clinic that offers services to these vulnerable
populations. I think it would be a great thing if we had one. WellStar is a great community partner. I
think if WellStar could reach out and assist with a community health clinic that could help the
underserved population of people in our county, it would be very beneficial.
CMS (Children’s Medical Services). Children’s Cabinet. Paulding County Community Support Services.
Our local food banks like Helping Hands of Paulding County provide good nutritional food to those in
need. They have wonderful volunteers that donate their time and talents to serve our citizens.
Comments: I am proud of WellStar Health System and am honored to serve on the Regional Board.
111
Examples of Community Survey Distribution including Social Media:
112
113
114
A.L. Burruss Institute’s Prioritization Tool for the Health Needs Summit – Feb. 25, 2016
(1)
115
(2)
116
(3)
117
(4)
118
(5)
119

APPENDICES: 2016 Community Health Needs Assessment

Transcription

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